The added diagnostic value of liquid gastric emptying compared with solid emptying alone

Area of Science:

• Gastroenterology
• Nuclear Medicine
• Diagnostic Imaging

Background:

• Medical literature suggests solid gastric emptying studies are more sensitive than liquid studies for gastroparesis diagnosis.
• Clinical observations indicate some patients exhibit normal solid emptying but delayed liquid emptying.
• The diagnostic utility of liquid gastric emptying studies in conjunction with solid studies requires further investigation.

Purpose of the Study:

• To evaluate the added diagnostic value of a clear liquid gastric emptying study compared to a solid emptying study alone for gastroparesis detection.
• To determine if liquid emptying studies provide incremental diagnostic information beyond solid emptying assessments.

Main Methods:

• 101 patients underwent sequential 30-minute liquid (using (111)In-DTPA) and 4-hour solid (using (99m)Tc-SC) gastric emptying studies.
• Liquid emptying quantified by half-emptying time (T1/2); solid emptying by percentage emptied at 4 hours.
• Normal liquid emptying values established from 30 healthy volunteers; analysis of (111)In downscatter into the (99m)Tc window.

Main Results:

• Delayed gastric emptying was identified in 36% of liquid studies versus 16% of solid studies.
• A significant proportion (32%) of patients with normal solid emptying demonstrated delayed liquid emptying.
• (111)In downscatter into the (99m)Tc window was generally not significant, validating the sequential study approach.

Conclusions:

• A 30-minute clear liquid gastric emptying study provides substantial added diagnostic value for gastroparesis.
• Liquid gastric emptying studies are crucial for a comprehensive diagnosis, complementing solid emptying assessments.
• Routine inclusion of liquid studies may improve gastroparesis detection rates.