Gastric emptying study | |
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Synonyms | Gastric emptying sccan, gastric emptying scintigraphy |
ICD-10-PCS | CD171ZZ |
OPS-301 code | 3-707 |
LOINC | 39768-7 |
A gastric emptying study is a nuclear medicine study which provides an assessment of the stomach's ability to empty. It may be used if there are complications after gastric surgery, for gastric reflux, or suspected gastroparesis amongst other indications. [1] Scintigraphy that uses gamma cameras to create two-dimensional images is generally regarded as the gold standard for gastric emptying. [2] [3]
Having fasted for around four hours before the study, the patient is given a solid or semi-solid meal, such as scrambled eggs on toast or porridge, which has been prepared with a radiopharmaceutical component. Typically technetium-99m sulphur colloid or DTPA is used. [4] [1] [5] Some studies may also involve a liquid component, which is labelled with indium-111 DTPA. [5] Images are acquired with a gamma camera, initially dynamically and then at intervals for up to 2-3 hours. [1] [5] [6]
The stomach time-activity curve is produced from geometric mean of anterior and posterior imaging. Half-emptying time, the lag-phase duration for solid studies, and percentage of food left at various time points are calculated. [7]
Single-photon emission computed tomography is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera, but is able to provide true 3D information. This information is typically presented as cross-sectional slices through the patient, but can be freely reformatted or manipulated as required.
Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitting from within the body rather than radiation that is generated by external sources like X-rays. In addition, nuclear medicine scans differ from radiology, as the emphasis is not on imaging anatomy, but on the function. For such reason, it is called a physiological imaging modality. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) scans are the two most common imaging modalities in nuclear medicine.
A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development and nuclear medical imaging to view and analyse images of the human body or the distribution of medically injected, inhaled, or ingested radionuclides emitting gamma rays.
Scintigraphy, also known as a gamma scan, is a diagnostic test in nuclear medicine, where radioisotopes attached to drugs that travel to a specific organ or tissue (radiopharmaceuticals) are taken internally and the emitted gamma radiation is captured by external detectors to form two-dimensional images in a similar process to the capture of x-ray images. In contrast, SPECT and positron emission tomography (PET) form 3-dimensional images and are therefore classified as separate techniques from scintigraphy, although they also use gamma cameras to detect internal radiation. Scintigraphy is unlike a diagnostic X-ray where external radiation is passed through the body to form an image.
Dumping syndrome occurs when food, especially sugar, moves too quickly from the stomach to the duodenum—the first part of the small intestine—in the upper gastrointestinal (GI) tract. This condition is also called rapid gastric emptying. It is mostly associated with conditions following gastric or esophageal surgery, though it can also arise secondary to diabetes or to the use of certain medications; it is caused by an absent or insufficiently functioning pyloric sphincter, the valve between the stomach and the duodenum.
A bone scan or bone scintigraphy is a nuclear medicine imaging technique of the bone. It can help diagnose a number of bone conditions, including cancer of the bone or metastasis, location of bone inflammation and fractures, and bone infection (osteomyelitis).
An electrogastrogram (EGG) is a computer generated graphic produced by electrogastrography, which detects, analyzes and records the myoelectrical signal generated by the movement of the smooth muscle of the stomach, intestines and other smooth muscle containing organs. An electrogastroenterogram or electroviscerogram is a similar display of the recording of myoelectrical activity of gastrointestinal or other organs which are able to generate myoelectrical activity.
Radioisotope renography is a form of medical imaging of the kidneys that uses radiolabelling. A renogram, which may also be known as a MAG3 scan, allows a nuclear medicine physician or a radiologist to visualize the kidneys and learn more about how they are functioning. MAG3 is an acronym for mercapto acetyl tri glycine, a compound that is chelated with a radioactive element – technetium-99m.
A ventilation/perfusion lung scan, also called a V/Q lung scan, or ventilation/perfusion scintigraphy, is a type of medical imaging using scintigraphy and medical isotopes to evaluate the circulation of air and blood within a patient's lungs, in order to determine the ventilation/perfusion ratio. The ventilation part of the test looks at the ability of air to reach all parts of the lungs, while the perfusion part evaluates how well blood circulates within the lungs. As Q in physiology is the letter used to describe bloodflow the term V/Q scan emerged.
Technetium-99m (99mTc) is a metastable nuclear isomer of technetium-99, symbolized as 99mTc, that is used in tens of millions of medical diagnostic procedures annually, making it the most commonly used medical radioisotope in the world.
Myocardial perfusion imaging or scanning is a nuclear medicine procedure that illustrates the function of the heart muscle (myocardium).
Gastroparesis, also called delayed gastric emptying, is a medical disorder consisting of weak muscular contractions (peristalsis) of the stomach, resulting in food and liquid remaining in the stomach for a prolonged period of time. Stomach contents thus exit more slowly into the duodenum of the digestive tract. This can result in irregular absorption of nutrients, inadequate nutrition, and poor glycemic control.
Technetium 99mTc albumin aggregated (99mTc-MAA) is an injectable radiopharmaceutical used in nuclear medicine. It consists of a sterile aqueous suspension of Technetium-99m (99mTc) labeled to human albumin aggregate particles. It is commonly used for lung perfusion scanning. It is also less commonly used to visualise a peritoneovenous shunt and for isotope venography.
Iobenguane, or MIBG, is an aralkylguanidine analog of the adrenergic neurotransmitter norepinephrine (noradrenaline), typically used as a radiopharmaceutical. It acts as a blocking agent for adrenergic neurons. When radiolabeled, it can be used in nuclear medicinal diagnostic and therapy techniques as well as in neuroendocrine chemotherapy treatments.
Scintimammography is a type of breast imaging test that is used to detect cancer cells in the breasts of some women who have had abnormal mammograms, or for those who have dense breast tissue, post-operative scar tissue or breast implants.
An octreotide scan is a type of SPECT scintigraphy used to find carcinoid, pancreatic neuroendocrine tumors, and to localize sarcoidosis. It is also called somatostatin receptor scintigraphy (SRS). Octreotide, a drug similar to somatostatin, is radiolabeled with indium-111, and is injected into a vein and travels through the bloodstream. The radioactive octreotide attaches to tumor cells that have receptors for somatostatin. A gamma camera detects the radioactive octreotide, and makes pictures showing where the tumor cells are in the body, typically by a SPECT technique. A technetium-99m based radiopharmaceutical kit is also available.
Perfusion is the passage of fluid through the lymphatic system or blood vessels to an organ or a tissue. The practice of perfusion scanning is the process by which this perfusion can be observed, recorded and quantified. The term perfusion scanning encompasses a wide range of medical imaging modalities.
Preoperative fasting is the practice of a surgical patient abstaining from eating or drinking for some time before having an operation. This is intended to prevent stomach contents from getting into the windpipe and lungs while the patient is under general anesthesia. The latest guidelines do not support preoperative fasting, as there is no difference in residual gastric fluid volume, pH or gastric emptying rate following semi-solid meals or drinks, whether in obese or lean individuals.
A DMSA scan is a radionuclide scan that uses dimercaptosuccinic acid (DMSA) in assessing renal morphology, structure and function. Radioactive technetium-99m is combined with DMSA and injected into a patient, followed by imaging with a gamma camera after 2-3 hours. A DMSA scan is usually static imaging, while other radiotracers like DTPA and MAG3 are usually used for dynamic imaging to assess renal excretion.
Dacryoscintigraphy (DSG), also known as lacrimal scintigraphy, is a nuclear medicine technique for imaging the lacrimal apparatus. It is used to identify obstructions, for example in the lacrimal duct, nasal cavity or nasolacrimal duct.