Gastric Emptying

Indications:
  • Insulin dependent diabetics with consistent pain or symptoms after eating meals
  • Diabetics with poor blood glucose control
  • Non-ulcer dyspepsia
  • severe reflux esophagitis
  • unexplained nausea and vomiting
  • red blood in the stool

Contraindications:
Some patients may be allergic to the meal ( Egg ALLERGY)
Fasting Diabetic Patients my result in hypoglycemia
Radiopharmaceutical information:
  • Radionuclide:Technicium
  • Radiopharmaceutical:Tc-99m-sulfer colloid
  • Adult dosing: 0.5-1 mCi
  • Pediatric dosing:
  • Method of administration:ingestion
  • Method of Localization: Compartmental tagged RBC's
  • Physical Half-life: 6hr
Patient Preparation: Patient should be NPO overnight or 4-6 hours. Patient should also hold any medications that can interfere with the study such as opiates, pepsid or any acid reflux pills.

Equipment Used:
Type of Camera or Probe - Dual Headed Gamma Camera
Collimator used: LEAP

Acquisition Setup:

Dynamic: View(s)
Matrix: 64 x 64
Time/Frame: 60
Number of Frames: 90

Statics: View(s)
Matrix:
Total Counts or Duration:

Whole body: View(s)
Matrix:
Scan Speed:
Start/stop points:

SPECT:
180 or 90 degree configuration
Total Rotation: 180 or 360
Starting point:
Matrix
Time/Azmuiths
Number of Azmuiths:

Procedure:
Describe the procedure from verifying the requisition to completing the scan. Include any patient instructions pre- or post- injection/scan, delays between injection and imaging, and any side effects.
While doing the patient history, i would make sure that the patient has been NPO overnight or even 4 hours. I would also make sure the patient has discontinued any medication that would cause a false positive. I would then describe to the patient that they are about to ingest a meal that contains the radioactive material needed for the test and ensure that there is no side affects and that they won't feel any different then they normally. I would cook the eggs in a microwave and place 1 mCi of the radioactive Tc-99m into the eggs and have it bind to the albumin. I would then make a sandwich with the eggs, two slices of toasted white bread, some jam and 120ml of water to wash it down. The patient would be wearing gloves during the meal to reduce exposure and take the images right after the patient eats the meal, not a real rush though. The patient would be laying supine and i would use the dual headed camera and place it over the stomach with the top of the field of the view at the bottom of the esophagus. I would take dynamic images for the full 90 minutes.

Normal Uptake and common varients:
Insert an image of a normal scan. Describe the normal uptake, and any normal varients visualized.

Abnormal Uptake and causes:
Insert an image of an abnormal scan. Describe the abnormal uptake, and the cause of the abnormal uptake.
external image GastricEmptying1%25.jpg

http://www.nuclearonline.org/newsletter/casestudy208.htm

In this study you can see an abnormal accumulation of of the tracer in the proximal small bowel with an abnormal time-counts curve. This means that the emptying rate of the stomach is abnormal and slower than usually with the accumulation of the tracer. This could indicate a possible obstruction in the bowel which would evidently create a faulty curve. According to the case report gastroparesis is a possible diagnosis that would cause the obstruction.
Artifacts:
Insert an image with an artifact, and explain what the artifact is.

Questions asked in Patient History:
List the common questions asked when taking a patient history for this specific procedure.

References: