Standardization of "In-House fatty meal" methodology for cholescintigraphy.

Area of Science:

• Nuclear Medicine
• Gastroenterology
• Diagnostic Imaging

Background:

• Cholescintigraphy is crucial for evaluating gallbladder function.
• Standardization of the fatty meal is needed for reproducible gallbladder ejection fraction (GBEF) measurements.
• Cholecystokinin is a common agent, but alternatives are sought.

Purpose of the Study:

• To standardize the "In-House fatty meal" protocol for cholescintigraphy.
• To determine the gallbladder ejection fraction (GBEF) using this standardized meal.
• To assess the diagnostic utility of GBEF at different time points.

Main Methods:

• A prospective case-control study included 61 patients and 59 healthy volunteers.
• (99m)Tc-mebrofenin fatty meal cholescintigraphy was performed with dynamic acquisitions.
• Gallbladder emptying kinetics and GBEF were calculated at 30, 45, and 60 minutes post-meal.

Main Results:

• In volunteers, mean GBEF was 74.42% ± 8.26% at 30 min, 82.61% ± 6.5% at 45 min, and 89.37% ± 4.48% at 60 min.
• The lower limit of normal GBEF at 30 min was 58%.
• Receiver operating characteristic (ROC) analysis showed 30-min GBEF had an area under the curve of 0.952, indicating excellent separation between healthy and diseased subjects.

Conclusions:

• The standardized in-house fatty meal is a well-tolerated and reproducible alternative to cholecystokinin.
• A 30-minute GBEF measurement effectively differentiates healthy individuals from those with gallbladder disease.
• Dynamic acquisitions beyond 30 minutes post-meal are likely not necessary, streamlining the procedure.