Multicenter validation of a shortened gastric-emptying protocol

Area of Science:

• Nuclear Medicine
• Gastroenterology
• Medical Imaging

Background:

• Gastric emptying scintigraphy (GES) is the gold standard for diagnosing gastroparesis but typically requires 4 hours.
• Current 4-hour GES protocols are inconvenient for patients.
• The Bonta criteria offer a potential 2-hour alternative to shorten GES protocols.

Purpose of the Study:

• To evaluate the accuracy and efficiency of the Bonta 2-hour criteria for gastric emptying scintigraphy in a multicenter trial.
• To compare the Bonta criteria against the established 4-hour Society of Nuclear Medicine and Molecular Imaging guidelines.

Main Methods:

• Retrospective analysis of 431 patients across 4 academic medical centers.
• Application of Bonta criteria (retention >65% abnormal, <45% normal) to 2-hour GES data.
• Comparison of Bonta criteria results with gold standard 4-hour GES findings for sensitivity, specificity, and accuracy.

Main Results:

• The Bonta criteria achieved 92.4% sensitivity, 96.9% specificity, and 95.8% accuracy.
• Utilizing Bonta criteria, 74.9% of studies could be terminated at 2 hours.
• This resulted in a 20.6% reduction in average study duration and a 15.7% decrease in camera use.

Conclusions:

• The Bonta 2-hour criteria effectively shorten GES duration for most patients.
• This approach offers a favorable balance between reduced resource utilization, enhanced patient convenience, and maintained diagnostic accuracy.
• The Bonta criteria represent a practical advancement in the clinical application of gastric emptying scintigraphy.