Comparison of gastric emptying of a nondigestible capsule to a radio-labelled meal in healthy and gastroparetic subjects

Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Alimentary Pharmacology & Therapeutics (Impact Factor: 4.55). 02/2008; 27(2):186-96. DOI: 10.1111/j.1365-2036.2007.03564.x
Source: PubMed

ABSTRACT Gastric emptying scintigraphy (GES) using a radio-labelled meal is used to measure gastric emptying. A nondigestible capsule, SmartPill, records luminal pH, temperature, and pressure during gastrointestinal transit providing a measure of gastric emptying time (GET).
To compare gastric emptying time and GES by assessing their correlation, and to compare GET and GES for discriminating healthy subjects from gastroparetics.
Eighty-seven healthy subjects and 61 gastroparetics enrolled with simultaneous SmartPill and GES. Fasted subjects were ingested capsule and [(99m)Tc]-SC radio-labelled meal. Images were obtained every 30 min for 6 h. Gastric emptying time and percentage of meal remaining at 2/4 h were determined for each subject. The sensitivity/specificity and receiver operating characteristic analysis of each measure were determined for each subject.
Correlation between GET and GES-4 h was 0.73 and GES-2 h was 0.63. The diagnostic accuracy from the receiver operating characteristic curve between gastroparetics and healthy subjects was GET = 0.83, GES-4 h = 0.82 and GES-2 h = 0.79. The 300-min cut-off time for GET gives sensitivity of 0.65 and specificity of 0.87 for diagnosis of gastroparesis. The corresponding sensitivity/specificity for 2 and 4 h standard GES measures were 0.34/0.93 and 0.44/0.93, respectively.
SmartPill GET correlates with GES and discriminates between healthy and gastroparetic subjects offering a nonradioactive, standardized, ambulatory alternative to scintigraphy.

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Available from: Jeff Lackner, Jul 17, 2015
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    • "This cutoff is defined by the 95th percentile in a healthy subject cohort [Tougas et al. 2000]. The WMC used a cutoff point of 5 h to mark delayed gastric emptying based on an analysis of the dataset from Kuo and colleagues providing val­ ues for sensitivity and specificity of 0.65 and 0.87, respectively [Kuo et al. 2008]. The increased detection of delayed emptying by WMC may be due to the fact that WMC GET reflects the function of the fasted state in addition to the fed state, whereas gastric scintigraphy typically meas­ ures fed state emptying only. "
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