Standardization of a technique for BrIDA cholescintigraphy

Calculation of ejection fraction by cholescintigraphy is a well-established technique to quantify motor function of the gallbladder. All previous cholescintigraphic studies of gallbladder emptying have exclusively used the anterior projection for gallbladder visualization. This may lead to inaccuracies because attenuation of gamma rays may vary depending on the state of gallbladder filling and body habitus. The use of geometric means may prevent these errors. In this study, 7 health volunteers were examined after the administration of 150 MBq 99Tcm-bromotrimethyl-IDA (99Tcm-BrIDA) without any stimulus and 9 volunteers ingested a maxied, fatty meal 35-40 min after BrIDA injection. Imaging was done using a dualheaded camera in a dynamic study of 140 one-minute frames. A plateau of activity was reached between 70 and 90 min post-injection of BrIDA and between 55-60% of maximal counts were achieved in the gallbladder region of interest (ROI) between 35 and 40 min. Significant emptying was seen in all nine subjects after the meal. No significant difference in ejection fraction was seen between the anterior projection and the geometric mean of the data from the anterier and posterior projections. The slope of the gallbladder filling curve from the anterior camera data was different from that obtained from the geometric mean, but the correlation coefficient was not significantly different. In conclusion, adequate counts are achieved in the gallbladder ROI 35-40 min after BrIDA injection, when the stimulus can be administered to study gallbladder emptying. There is no advantage to imaging in the anterior and posterior projections and data obtained from the anterior projection alone are adequate for gallbladder emptying studies.