Gallbladder response to a second dose of cholecystokinin during the same imaging study

Area of Science:

• Hepatobiliary imaging
• Gastroenterology
• Nuclear medicine

Background:

• Patients on total parenteral nutrition or after prolonged fasting may need cholecystokinin (CCK) for hepatobiliary imaging.
• Gallbladder (GB) contractility evaluation might require a second CCK dose.
• The efficacy of a second CCK dose for GB function assessment after a prior dose is unclear.

Purpose of the Study:

• To evaluate gallbladder (GB) response to a second cholecystokinin (CCK) injection in normal subjects.
• To determine if GB function can be adequately assessed with CCK after a previous dose.
• To establish expected gallbladder ejection fraction (GBEF) values following a second CCK dose.

Main Methods:

• Ten healthy subjects received an initial 20 micrograms/kg sincalide (CCK) dose.
• Technetium-99m disofenin was administered for hepatobiliary imaging.
• A second identical sincalide dose was given at 60 minutes postinjection, with imaging for 30 minutes to quantify GB contraction.

Main Results:

• Gallbladder ejection fraction (GBEF) values ranged from 42-98%, with a mean of 71.5 +/- 19%.
• Pretreatment with CCK did not prevent GB contraction evaluation with a second dose.
• The GBEF values obtained were comparable to those from single CCK injections.

Conclusions:

• A second dose of cholecystokinin (CCK) can be effectively used to evaluate gallbladder (GB) function.
• This method is reliable for assessing gallbladder ejection fraction (GBEF) even after an initial CCK administration.
• Findings support the use of a second CCK dose for comprehensive GB assessment in clinical practice.