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Esophageal scintigraphy: reproducibility and normal ranges.
F Jørgensen1, B Hesse, N Tromholt
1Department of Clinical Physiology, County Hospital of Hillerød, Denmark.
Summary
Esophageal scintigraphy using radiolabeled water can reliably measure mean transit time in healthy adults. However, residual activity measurements show high variability, limiting their diagnostic value.
Area of Science:
- Gastroenterology
- Nuclear Medicine
- Physiology
Background:
- Esophageal scintigraphy is widely used but debated for screening esophageal dysfunction.
- Limited data exists on normal ranges, age dependence, and reproducibility.
- Radionuclide imaging provides functional assessment of esophageal motility.
Purpose of the Study:
- Establish normal ranges for esophageal mean transit time (MTT) and residual activity.
- Assess age-related variations and reproducibility of these parameters.
- Evaluate the utility of scintigraphy for diagnosing esophageal motility disorders.
Main Methods:
- Studied 60 healthy subjects across different age groups (20-79 years).
- Utilized [99mTc] pertechnetate labeled water for radionuclide imaging.
- Calculated MTT using Zierler's formula and measured residual activity.
- Performed single and double measurements in sitting and supine positions.
Main Results:
- Median MTT was 6.1 seconds and median residual activity was 11.5% in the supine position.
- Double measurements significantly reduced variability for MTT (CV 10%) compared to single measurements (CV 20-35%).
- Residual activity measurements showed high variability (CV 85-120%) even with double measurements.
Conclusions:
- Esophageal mean transit time measured by double scintigraphy is reproducible and age-independent in healthy individuals.
- Residual activity measurements exhibit unacceptable variability, limiting their clinical application.
- Esophageal scintigraphy is a valuable tool for assessing esophageal transit, but residual activity requires further refinement.