Variation in gastric emptying scintigraphy protocols in Australia and New Zealand: An online survey

Standardisation of nuclear medicine practice is important for high-quality patient care. Variation in protocols limits the ability to compare results between departments and may reduce confidence in results. The aim of this study was to determine the current extent of variation in gastric emptying scintigraphy (GES) protocols in Australian and New Zealand departments of nuclear medicine.

A cross-sectional, online survey of Nuclear Medicine Technologists (NMTs) was conducted using 'LimeSurvey'. The survey was distributed to 442 NMT members of the Australian and New Zealand Society of Nuclear Medicine over a period of two months. The survey comprised 27 questions relating to participant information, patient preparation, test meal, scanning, processing, and alternative meals used as part of their departmental protocol; the number of questions increased to 34 if the department had an alternative meal/technique.

A total of 141 responses were received, resulting in a response rate of 31.9%. Once responses were reviewed for completeness or duplicates (data coming from the same department), a total of 37 responses from NMTs, representing their department, (31 from Australia and six from New Zealand) were included in the final analysis. Nineteen (51.3%) NMTs had a variation of a meal based on the Society of Nuclear Medicine and Molecular Imaging (SNMMI) / American Neurogastroenterology Motility Society (ANMS) guidelines. The majority (n = 30, 81.0%) of participants utilised a single isotope technique, labelling the solid component only. All but two (94.6%) NMTs included an egg component to their test meal. For scanning, the majority (n = 25,67.6%) of NMTs acquired the scintigraphic data with the patient supine. Only 30% (n = 11) of NMTs corrected for attenuation when processing GES data. Of the 32 (86.4%) NMTs that had an alternative meal, only one (2.7%) had a normal range specific to the meal.

The results demonstrated marked variation amongst departmental protocols in Australia and New Zealand, particularly in relation to appropriate normal ranges. This study highlights the importance of a current lack of standardisation of practice in Australian and New Zealand departments in relation to GES protocols.