New imaging in neurogastroenterology: an overview

Advances in imaging are being introduced initially as research tools and subsequently as clinical diagnostic tests. These investigations include modifications of the standard gastric emptying by scintigraphy to include application of intraluminal ultrasound to image sustained contractions and longitudinal shortening in the oesophagus, 2- and 4-h images, volumetric measurements to measure gastric volume, magnetic resonance (MR) imaging to appraise the structure and function of the rectal evacuation process, and brain imaging as a surrogate for the investigation of the brain's contribution to functional gastrointestinal disorders and chronic pain syndromes. There is a need for rigorous validation and measurement of the performance characteristics of these tests. Given the impact of gastric emptying at 4 h and single photon emission computerized tomography (SPECT) imaging for measuring gastric volumes on research and clinical practice, it is anticipated that, once validated, these different techniques are likely to have a significant impact on neurogastroenterology and, potentially, replace more invasive procedures.