Information de reference pour ce titreAccession Number: | 00001716-200801000-00008.
|
Author: | KUO, B. *; MCCALLUM, R. W. +; KOCH, K. L. ++; SITRIN, M. D. [S]; WO, J. M. [P]; CHEY, W. D. *,*; HASLER, W. L. *,*; LACKNER, J. M. ++; KATZ, L. A. ++++; SEMLER, J. R. [S][S]; WILDING, G. E. [P][P]; PARKMAN, H. P. ***
|
Institution: | (*)Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; (+)Center for Gastrointestinal Nerve & Muscle Function & GI Motility, University of Kansas Medical Center, Kansas City, KS, USA; (++)Section on Gastroenterology, Wake Forest University Baptist Medical Center, Winston Salem, NC, USA; ([S])Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Western New York VA Medical Center, SUNY at Buffalo, Buffalo, NY, USA; ([P])Division of Gastroenterology/Hepatology, University of Louisville, Louisville, KY, USA; (**)Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; (++)Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Behavioral Medicine Clinic, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA; (++++)Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA; ([S][S])The SmartPill Corporation, Buffalo, NY, USA; ([P][P])Department of Biostatistics, SUNY at Buffalo, Buffalo, NY, USA; (***)Gastroenterology Section, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA
|
Title: | |
Source: | Alimentary Pharmacology & Therapeutics. 27(2):186-196, January 2008.
|
Abstract: | Background: Gastric emptying scintigraphy (GES) using a radio-labelled meal is used to measure gastric emptying. A nondigestible capsule, SmartPill, records luminal pH, temperature, and pressure during gastrointestinal transit providing a measure of gastric emptying time (GET).
Aims: To compare gastric emptying time and GES by assessing their correlation, and to compare GET and GES for discriminating healthy subjects from gastroparetics.
Methods: Eighty-seven healthy subjects and 61 gastroparetics enrolled with simultaneous SmartPill and GES. Fasted subjects were ingested capsule and [99mTc]-SC radio-labelled meal. Images were obtained every 30 min for 6 h. Gastric emptying time and percentage of meal remaining at 2/4 h were determined for each subject. The sensitivity/specificity and receiver operating characteristic analysis of each measure were determined for each subject.
Results: Correlation between GET and GES-4 h was 0.73 and GES-2 h was 0.63. The diagnostic accuracy from the receiver operating characteristic curve between gastroparetics and healthy subjects was GET = 0.83, GES-4 h = 0.82 and GES-2 h = 0.79. The 300-min cut-off time for GET gives sensitivity of 0.65 and specificity of 0.87 for diagnosis of gastroparesis. The corresponding sensitivity/specificity for 2 and 4 h standard GES measures were 0.34/0.93 and 0.44/0.93, respectively.
Conclusion: SmartPill GET correlates with GES and discriminates between healthy and gastroparetic subjects offering a nonradioactive, standardized, ambulatory alternative to scintigraphy.
Copyright (C) 2008 Blackwell Publishing Ltd.
|
References: | 1 Parkman HP, Hasler WL, Fisher RS. AGA technical review on the diagnosis and treatment of gastroparesis. Gastroenterology 2004; 127: 1592-622.
2 Russell TL, Berardi RR, Barnett JL, et al. Upper gastrointestinal pH in seventy-nine healthy, elderly, North American men and women. Pharm Res 1993; 10: 187-96.
3 Cremoni F, Mullan BP, Camilleri M, Burton DD, Rank MR. Performance characteristics of scintigraphic transit measurements for studies of experimental therapies. Aliment Pharmacol Ther 2002; 16: 1781-90.
4 Choi MG, Burton DD, Zinsmeister AR, Forstrom LA, Nair KS. C13 octanoic acid breath test for gastric emptying of solids: accuracy, reproducibility, and comparison with scintigraphy. Gastroenterology 1997; 112: 1155-62.
5 Kuo B, Viazis N, Bahadur S, Sitrin M, Lackner J, Semler J. Non-invasive simultaneous measurement of intra-luminal pH and pressure: assessment of gastric emptying and upper GI manometry in healthy subjects. Neurogastroenterology 2004; 16: 666.
6 Locke GR, Talley NJ, Weaver AL, Zinsmeister AR. A new questionnaire for gastroesophageal reflux disease. Mayo Clin Proc 1994; 69: 539-47.
7 Mojaverian P, Chan K, Desai A, John V. Gastrointestinal transit of a solid indigestible capsule as measured by radiotelemetry and dual gamma scintigraphy. Pharm Res 1989; 6: 719-44.
8 Gordon SJ, Mojaverian P, Kellner PE, Vlasses PH. Measurement of gastric residence time (GRT) by Heidelberg capsule (HC) reproducibility in normal subjects and application in diabetic gastroparesis. Gastroenterology 1987; 92 (Pt 2): 1410-1410.
9 Mojaverian P, Ferguson RK, Vlasses PH, et al. Estimation of gastric residence time of the Heidelberg capsule in humans: effect of varying food composition. Gastroenterology 1985; 89: 392-7.
10 Evans DF, Pye G, Bramley R, Clark AG, Dyson TJ, Hardcastle JD. Measurement of gastrointestinal pH profiles in normal ambulant subjects. Gut 1988; 29: 1035-41.
11 Tougas G, Eaker EY, Abell TL, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol 2000; 95: 1456-62.
12 Faegenburg D, Kryle LS, Kashiwabara H, Doctor NH, Pai P. Intestinal obstruction caused by ingestion of a Heidelberg capsule: report of a case. Am J Gastroenterol 1985; 80: 787-9.
13 Fleischer DE, Heigh RI, Nguyen CC, Leighton JA, Sharma VK, Musil D. Video capsule endoscopy (VCE) is useful in the evaluation of unexplained abdominal pain (AP). Gastroenterology 2003; 200 (Pt 2): 245.
14 Jones BH, Fleischer DE, Sharma VK, et al. Yield of repeat wireless capsule endoscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005; 100: 1058-64.
15 Klein JP, Moeschberger ML. Survival Analysis: Techniques for Censored and Truncated Data. New York: Springer-Verlag, 2003.
16 Feldman M, Smith HJ, Simon TR. Gastric emptying of solid radiopaque markers: studies in healthy subjects and diabetic patients. Gastroenterology 1984; 87: 895-902.
17 Cassilly DW, Kantor S, Knight L, Maurer A, Fisher RS, Parkman HP. Simultaneous use of SmartPill pH and pressure capsule, antroduodenal manometry and gastric emptying scintigraphy to assess gastric emptying of digestible and non-digestible solids. Gastroenterology 2007; 132 ((4, Suppl. 2)): A-97.
18 Rao SS, McCallum R, Parkman HP, et al. A comparative study of SmartPill and radioopaque markers for the assessment of colonic transit time in humans. Gastroenterology 2007; 132 ((4, Suppl. 2)): A-458.
|
Language: | English.
|
Document Type: | Original article.
|
Journal Subset: | Clinical Medicine.
|
ISSN: | 0269-2813
|
NLM Journal Code: | a5d, 8707234
|
Annotation(s) | |
|
|