Normative values for esophageal functional lumen imaging probe measurements: A meta-analysis

Area of Science:

• Gastroenterology
• Medical Devices
• Physiology

Background:

• The functional lumen imaging probe (Endoflip™) is increasingly utilized for assessing esophageal symptoms.
• Establishing normative values and cut-off points is crucial for accurate Endoflip™ interpretation in clinical practice.

Purpose of the Study:

• To determine normative values and appropriate cut-off values for the esophagogastric junction distensibility index (EGJ-DI) measured by Endoflip™ in healthy adults.
• To provide guidance for the clinical interpretation of Endoflip™ measurements.

Main Methods:

• A systematic review and meta-analysis of original clinical studies on Endoflip™ use in healthy adults.
• Inclusion of 17 articles for systematic review and 15 for meta-analysis, totaling 154 unique subjects.

Main Results:

• Percentiles for EGJ-DI were calculated at 40, 50, and 60 ml distention volumes.
• At 40 ml, 5.4% of healthy subjects had an EGJ-DI below 2 mm²/mmHg; at 50 ml, 0.6%; and at 60 ml, 0.0%.
• A clear cut-off for lower EGJ-DI values was identified, while upper limits showed considerable variability.

Conclusions:

• A recommended clinical cut-off of 2 mm²/mmHg for EGJ-DI is proposed, with values below this considered abnormal.
• Utilizing 50 and 60 ml distention volumes is suggested due to lower prevalence of values below the cut-off in healthy individuals.
• The clinical utility of an upper limit for normal EGJ-DI appears questionable.