Can an Abnormal Gastric Emptying Study Be Normal?

Abstract

The American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine and Molecular Imaging collaboratively wrote consensus statements to standardize gastric emptying scintigraphy. Despite this, centers are using nonstandard protocols. This study examined how these protocols contrast with standards. Methods: Consecutive charts were analyzed for meal, radionuclide dose, half-emptying time (T½) and its normal range, and documented retention and emptying. Impressions were compared with how emptying mapped on a graph based on standard 4-h values. Results: Thirty-four studies were identified. Ten of 14 abnormal studies were normal when plotted on the standard 4-h graph. Eight of 10 abnormal studies had normal 2- or 4-h retention. Normal T½ ranges varied significantly. Most altered the meal, and over 25% received a radionucleotide dose outside the recommended range. Conclusion: The upper bound of normal T½ falls within standard 4-h bounds, with many individuals given an erroneous impression. Though further optimization may be needed, adhering to standards is critical.