A Stable Isotope Breath Test With a Standard Meal for Abnormal Gastric Emptying of Solids in the Clinic and in Research

Lawrence Szarka, Michael Camilleri, Adrian Vella, Duane Burton, Kari Baxter, Julie Simonson, Alan R. Zinsmeister

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Background & Aims: The aim of this study was to validate a [13C]-Spirulina platensis gastric emptying (GE) breath test (GEBT) with a standardized meal. Methods: Thirty-eight healthy volunteers and 129 patients with clinically suspected delayed GE underwent measurements at 45, 90, 120, 150, 180, and 240 minutes after a 238 kcal meal labeled test with 100 mg [13C]-S platensis and 0.5 mCi 99mTc. We established normal ranges for scintigraphy with this test meal, intraindividual and interindividual coefficients of variation (COVs), and the ability of the [13C] GEBT breath percent dose excreted *1000 values to predict scintigraphic half-life and to categorize GE as delayed, normal, or accelerated. Results: In health, the 10th and 90th percentiles of half-life for scintigraphic GE with this meal were 52 and 86 minutes; intraindividual COVs for scintigraphy and the GEBT were, respectively, 31% and 27% at 45 minutes, 17% and 21% at 90 minutes, 13% and 16% at 120 minutes, 10% and 13% at 150 minutes, and 8% and 12% at 180 minutes. Interindividual COVs at each time for the [13C] GEBT and scintigraphy were typically ∼1%-4% lower than intraindividual COVs. Individual breath samples at 45, 150, and 180 minutes predicted GE category; at 80% specificity, 45- and 180-minute samples combined were 93% sensitive to identify accelerated GE, and 150- and 180-minute combined were 89% sensitive for delayed GE. Conclusions: [13C]-S platensis GEBT is as reproducible as scintigraphy; imprecision with both tests reflects physiologic variation. With 4 breath samples, this method with an off-the-shelf meal is valid to assess GE in clinic and in research.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
Volume6
Issue number6
DOIs
StatePublished - Jun 2008

Fingerprint

Breath Tests
Gastric Emptying
Isotopes
Meals
Research
Radionuclide Imaging
Half-Life
Spirulina
Healthy Volunteers
Reference Values
Health

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A Stable Isotope Breath Test With a Standard Meal for Abnormal Gastric Emptying of Solids in the Clinic and in Research. / Szarka, Lawrence; Camilleri, Michael; Vella, Adrian; Burton, Duane; Baxter, Kari; Simonson, Julie; Zinsmeister, Alan R.

In: Clinical Gastroenterology and Hepatology, Vol. 6, No. 6, 06.2008.

Research output: Contribution to journalArticle

@article{4abb67e2f37942a08e90a2d7789f0445,
title = "A Stable Isotope Breath Test With a Standard Meal for Abnormal Gastric Emptying of Solids in the Clinic and in Research",
abstract = "Background & Aims: The aim of this study was to validate a [13C]-Spirulina platensis gastric emptying (GE) breath test (GEBT) with a standardized meal. Methods: Thirty-eight healthy volunteers and 129 patients with clinically suspected delayed GE underwent measurements at 45, 90, 120, 150, 180, and 240 minutes after a 238 kcal meal labeled test with 100 mg [13C]-S platensis and 0.5 mCi 99mTc. We established normal ranges for scintigraphy with this test meal, intraindividual and interindividual coefficients of variation (COVs), and the ability of the [13C] GEBT breath percent dose excreted *1000 values to predict scintigraphic half-life and to categorize GE as delayed, normal, or accelerated. Results: In health, the 10th and 90th percentiles of half-life for scintigraphic GE with this meal were 52 and 86 minutes; intraindividual COVs for scintigraphy and the GEBT were, respectively, 31{\%} and 27{\%} at 45 minutes, 17{\%} and 21{\%} at 90 minutes, 13{\%} and 16{\%} at 120 minutes, 10{\%} and 13{\%} at 150 minutes, and 8{\%} and 12{\%} at 180 minutes. Interindividual COVs at each time for the [13C] GEBT and scintigraphy were typically ∼1{\%}-4{\%} lower than intraindividual COVs. Individual breath samples at 45, 150, and 180 minutes predicted GE category; at 80{\%} specificity, 45- and 180-minute samples combined were 93{\%} sensitive to identify accelerated GE, and 150- and 180-minute combined were 89{\%} sensitive for delayed GE. Conclusions: [13C]-S platensis GEBT is as reproducible as scintigraphy; imprecision with both tests reflects physiologic variation. With 4 breath samples, this method with an off-the-shelf meal is valid to assess GE in clinic and in research.",
author = "Lawrence Szarka and Michael Camilleri and Adrian Vella and Duane Burton and Kari Baxter and Julie Simonson and Zinsmeister, {Alan R.}",
year = "2008",
month = "6",
doi = "10.1016/j.cgh.2008.01.009",
language = "English (US)",
volume = "6",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - A Stable Isotope Breath Test With a Standard Meal for Abnormal Gastric Emptying of Solids in the Clinic and in Research

AU - Szarka, Lawrence

AU - Camilleri, Michael

AU - Vella, Adrian

AU - Burton, Duane

AU - Baxter, Kari

AU - Simonson, Julie

AU - Zinsmeister, Alan R.

PY - 2008/6

Y1 - 2008/6

N2 - Background & Aims: The aim of this study was to validate a [13C]-Spirulina platensis gastric emptying (GE) breath test (GEBT) with a standardized meal. Methods: Thirty-eight healthy volunteers and 129 patients with clinically suspected delayed GE underwent measurements at 45, 90, 120, 150, 180, and 240 minutes after a 238 kcal meal labeled test with 100 mg [13C]-S platensis and 0.5 mCi 99mTc. We established normal ranges for scintigraphy with this test meal, intraindividual and interindividual coefficients of variation (COVs), and the ability of the [13C] GEBT breath percent dose excreted *1000 values to predict scintigraphic half-life and to categorize GE as delayed, normal, or accelerated. Results: In health, the 10th and 90th percentiles of half-life for scintigraphic GE with this meal were 52 and 86 minutes; intraindividual COVs for scintigraphy and the GEBT were, respectively, 31% and 27% at 45 minutes, 17% and 21% at 90 minutes, 13% and 16% at 120 minutes, 10% and 13% at 150 minutes, and 8% and 12% at 180 minutes. Interindividual COVs at each time for the [13C] GEBT and scintigraphy were typically ∼1%-4% lower than intraindividual COVs. Individual breath samples at 45, 150, and 180 minutes predicted GE category; at 80% specificity, 45- and 180-minute samples combined were 93% sensitive to identify accelerated GE, and 150- and 180-minute combined were 89% sensitive for delayed GE. Conclusions: [13C]-S platensis GEBT is as reproducible as scintigraphy; imprecision with both tests reflects physiologic variation. With 4 breath samples, this method with an off-the-shelf meal is valid to assess GE in clinic and in research.

AB - Background & Aims: The aim of this study was to validate a [13C]-Spirulina platensis gastric emptying (GE) breath test (GEBT) with a standardized meal. Methods: Thirty-eight healthy volunteers and 129 patients with clinically suspected delayed GE underwent measurements at 45, 90, 120, 150, 180, and 240 minutes after a 238 kcal meal labeled test with 100 mg [13C]-S platensis and 0.5 mCi 99mTc. We established normal ranges for scintigraphy with this test meal, intraindividual and interindividual coefficients of variation (COVs), and the ability of the [13C] GEBT breath percent dose excreted *1000 values to predict scintigraphic half-life and to categorize GE as delayed, normal, or accelerated. Results: In health, the 10th and 90th percentiles of half-life for scintigraphic GE with this meal were 52 and 86 minutes; intraindividual COVs for scintigraphy and the GEBT were, respectively, 31% and 27% at 45 minutes, 17% and 21% at 90 minutes, 13% and 16% at 120 minutes, 10% and 13% at 150 minutes, and 8% and 12% at 180 minutes. Interindividual COVs at each time for the [13C] GEBT and scintigraphy were typically ∼1%-4% lower than intraindividual COVs. Individual breath samples at 45, 150, and 180 minutes predicted GE category; at 80% specificity, 45- and 180-minute samples combined were 93% sensitive to identify accelerated GE, and 150- and 180-minute combined were 89% sensitive for delayed GE. Conclusions: [13C]-S platensis GEBT is as reproducible as scintigraphy; imprecision with both tests reflects physiologic variation. With 4 breath samples, this method with an off-the-shelf meal is valid to assess GE in clinic and in research.

UR - http://www.scopus.com/inward/record.url?scp=44749093426&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44749093426&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2008.01.009

DO - 10.1016/j.cgh.2008.01.009

M3 - Article

C2 - 18406670

AN - SCOPUS:44749093426

VL - 6

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 6

ER -