Comprehensive assessment of gastric emptying with a stable isotope breath test

Adil Eddie Bharucha, Michael Camilleri, E. Veil, D. Burton, A. R. Zinsmeister

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background The [13C]-Spirulina platensis gastric emptying breath test (GEBT) with five samples is accurate relative to scintigraphy. This study was primarily designed to further validate this GEBT using a slightly different process for incorporating [13C] in Spirulina and to evaluate the utility of additional samples for assessing early gastric emptying. Methods After a 223kcal, test meal labeled with 99mTc and [13C]-S. platensis, scintigraphic images, and five breath samples (45, 90, 120, 180, and 240min, GEBT5) were collected in 14 controls (Part A). In Part B, nine breath samples were collected at 15, 30, 45, 60, 90, 120, 150, 180, and 240min (GEBT9) in 30 subjects (15 controls, 15 dyspepsia). Using correlation between [13C] breath excretion and scintigraphic emptying, lag time (t10, time for 10% emptying), emptying at 30min (GE30), and half time (t50) were estimated for GEBT5 (Parts A and B) and GEBT9 (Part B). Key Results Half time values for scintigraphy, GEBT5, and GEBT9 were highly concordant. t10 by GEBT9 (90%CI, 6-15min) was more strongly correlated [CCC 0.80 (95% CI, 0.63-0.90)] with scintigraphy (90% CI, 5-12min), than GEBT5 [10-19min, CCC 0.73 (95% CI, 0.54-0.85)]. The correlation between estimated values (GEBT9) and linearly interpolated values (GEBT5) was closer at 60 [CCC 0.95 (95% CI, 0.91-0.97)] than 30min [CCC 0.81 (95% CI, 0.71-0.89)]. Conclusions & Inferences The [13C]-S. platensis GEBT can accurately measure GE. While 5- and 9-samples are equally accurate for measuring t50, GEBT9 provides a more comprehensive assessment of early GE (t10 and GE30).

Original languageEnglish (US)
JournalNeurogastroenterology and Motility
Volume25
Issue number1
DOIs
StatePublished - Jan 2013

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Breath Tests
Gastric Emptying
Isotopes
Radionuclide Imaging
Spirulina
Dyspepsia
Meals

Keywords

  • Breath test
  • Dumping
  • Dyspepsia
  • Gastric emptying
  • Gastroparesis

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Gastroenterology
  • Physiology

Cite this

Comprehensive assessment of gastric emptying with a stable isotope breath test. / Bharucha, Adil Eddie; Camilleri, Michael; Veil, E.; Burton, D.; Zinsmeister, A. R.

In: Neurogastroenterology and Motility, Vol. 25, No. 1, 01.2013.

Research output: Contribution to journalArticle

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abstract = "Background The [13C]-Spirulina platensis gastric emptying breath test (GEBT) with five samples is accurate relative to scintigraphy. This study was primarily designed to further validate this GEBT using a slightly different process for incorporating [13C] in Spirulina and to evaluate the utility of additional samples for assessing early gastric emptying. Methods After a 223kcal, test meal labeled with 99mTc and [13C]-S. platensis, scintigraphic images, and five breath samples (45, 90, 120, 180, and 240min, GEBT5) were collected in 14 controls (Part A). In Part B, nine breath samples were collected at 15, 30, 45, 60, 90, 120, 150, 180, and 240min (GEBT9) in 30 subjects (15 controls, 15 dyspepsia). Using correlation between [13C] breath excretion and scintigraphic emptying, lag time (t10, time for 10{\%} emptying), emptying at 30min (GE30), and half time (t50) were estimated for GEBT5 (Parts A and B) and GEBT9 (Part B). Key Results Half time values for scintigraphy, GEBT5, and GEBT9 were highly concordant. t10 by GEBT9 (90{\%}CI, 6-15min) was more strongly correlated [CCC 0.80 (95{\%} CI, 0.63-0.90)] with scintigraphy (90{\%} CI, 5-12min), than GEBT5 [10-19min, CCC 0.73 (95{\%} CI, 0.54-0.85)]. The correlation between estimated values (GEBT9) and linearly interpolated values (GEBT5) was closer at 60 [CCC 0.95 (95{\%} CI, 0.91-0.97)] than 30min [CCC 0.81 (95{\%} CI, 0.71-0.89)]. Conclusions & Inferences The [13C]-S. platensis GEBT can accurately measure GE. While 5- and 9-samples are equally accurate for measuring t50, GEBT9 provides a more comprehensive assessment of early GE (t10 and GE30).",
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AU - Camilleri, Michael

AU - Veil, E.

AU - Burton, D.

AU - Zinsmeister, A. R.

PY - 2013/1

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N2 - Background The [13C]-Spirulina platensis gastric emptying breath test (GEBT) with five samples is accurate relative to scintigraphy. This study was primarily designed to further validate this GEBT using a slightly different process for incorporating [13C] in Spirulina and to evaluate the utility of additional samples for assessing early gastric emptying. Methods After a 223kcal, test meal labeled with 99mTc and [13C]-S. platensis, scintigraphic images, and five breath samples (45, 90, 120, 180, and 240min, GEBT5) were collected in 14 controls (Part A). In Part B, nine breath samples were collected at 15, 30, 45, 60, 90, 120, 150, 180, and 240min (GEBT9) in 30 subjects (15 controls, 15 dyspepsia). Using correlation between [13C] breath excretion and scintigraphic emptying, lag time (t10, time for 10% emptying), emptying at 30min (GE30), and half time (t50) were estimated for GEBT5 (Parts A and B) and GEBT9 (Part B). Key Results Half time values for scintigraphy, GEBT5, and GEBT9 were highly concordant. t10 by GEBT9 (90%CI, 6-15min) was more strongly correlated [CCC 0.80 (95% CI, 0.63-0.90)] with scintigraphy (90% CI, 5-12min), than GEBT5 [10-19min, CCC 0.73 (95% CI, 0.54-0.85)]. The correlation between estimated values (GEBT9) and linearly interpolated values (GEBT5) was closer at 60 [CCC 0.95 (95% CI, 0.91-0.97)] than 30min [CCC 0.81 (95% CI, 0.71-0.89)]. Conclusions & Inferences The [13C]-S. platensis GEBT can accurately measure GE. While 5- and 9-samples are equally accurate for measuring t50, GEBT9 provides a more comprehensive assessment of early GE (t10 and GE30).

AB - Background The [13C]-Spirulina platensis gastric emptying breath test (GEBT) with five samples is accurate relative to scintigraphy. This study was primarily designed to further validate this GEBT using a slightly different process for incorporating [13C] in Spirulina and to evaluate the utility of additional samples for assessing early gastric emptying. Methods After a 223kcal, test meal labeled with 99mTc and [13C]-S. platensis, scintigraphic images, and five breath samples (45, 90, 120, 180, and 240min, GEBT5) were collected in 14 controls (Part A). In Part B, nine breath samples were collected at 15, 30, 45, 60, 90, 120, 150, 180, and 240min (GEBT9) in 30 subjects (15 controls, 15 dyspepsia). Using correlation between [13C] breath excretion and scintigraphic emptying, lag time (t10, time for 10% emptying), emptying at 30min (GE30), and half time (t50) were estimated for GEBT5 (Parts A and B) and GEBT9 (Part B). Key Results Half time values for scintigraphy, GEBT5, and GEBT9 were highly concordant. t10 by GEBT9 (90%CI, 6-15min) was more strongly correlated [CCC 0.80 (95% CI, 0.63-0.90)] with scintigraphy (90% CI, 5-12min), than GEBT5 [10-19min, CCC 0.73 (95% CI, 0.54-0.85)]. The correlation between estimated values (GEBT9) and linearly interpolated values (GEBT5) was closer at 60 [CCC 0.95 (95% CI, 0.91-0.97)] than 30min [CCC 0.81 (95% CI, 0.71-0.89)]. Conclusions & Inferences The [13C]-S. platensis GEBT can accurately measure GE. While 5- and 9-samples are equally accurate for measuring t50, GEBT9 provides a more comprehensive assessment of early GE (t10 and GE30).

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KW - Dumping

KW - Dyspepsia

KW - Gastric emptying

KW - Gastroparesis

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