In vitro Study to Compare Stability and Homogeneity of Various Routinely Used Meals for Gastric Emptying Scintigraphy (GES) for Solids and Validating Radiolabeled Idli (Savory Cake) as an Improved Alternate Vegetarian Meal.

Purpose: The purpose of the study was to compare the stability and homogeneity of various routinely used meals for gastric emptying scintigraphy (GES) for solids and to validate an improved vegetarian well uniformly radiolabeled solid meal for GES, which is easily fully consumed by patients in view of their common symptoms in such indications and in keeping with Indian food culture.

Materials and methods: Following various types of solid meal preparations were labeled with 3 mCi of 99 mTc sulfur colloid (SC), and image of each meal was acquired on General Electric (GE) Infinia Hawkeye 4 camera: (1) Meal of 4 slice bread + 20 g butter with calorific value ≈ 356 kcal. (2) 4 slice bread + 30 g jam with calorific value ≈ 332 kcal. (3) 4 slice bread + 70 ml of milk with calorific value ≈ 243 kcal. (4) 150 g of sagu (sabudana) +5 ml refined vegetable oil + 10 g peanuts (sagu khichdi) with calorific value ≈ 324 kcal. (5) 4 idli + 2 tablespoon green chutney with calorific value ≈ 280 kcal. (6) 70 g wheat + 50 ml water + 5 ml refined vegetable oil with calorific value ≈ 237 kcal. (7) Meal of 75 g of idli mix + 80 ml water + 10 g butter with calorific value ≈ 310 kcal. All radiolabeled meals were subjected to the radiolabeled stability test procedure to calculate labeling efficiency which was compared.

Results: Idli meal prepared with radiotracer added to the batter mixture itself, with a calorific value ≈ 310 kcal showed the highest uniform Tc99 m SC distribution in comparison to all other meal preparations.

Conclusions: Radiolabeled idli (savory cake) prepared with radiotracer added to the batter mixture itself, appears to be an ideal vegetarian meal in comparison to all other meal preparations for gastric emptying scintigraphy studies, especially among patients with specific dietary restrictions.