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Research ArticleImaging

Kinetics of Gallbladder Emptying During Cholecystokinin Cholescintigraphy as an Indicator of In Vivo Hormonal Sensitivity

Laurence J. Miller, Kaleeckal G. Harikumar, Aditya J. Desai, Hassan Siddiki and Ba D. Nguyen
Journal of Nuclear Medicine Technology March 2020, 48 (1) 40-45; DOI: https://doi.org/10.2967/jnmt.119.233486
Laurence J. Miller
1Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Scottsdale, Arizona
2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona; and
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Kaleeckal G. Harikumar
1Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Scottsdale, Arizona
2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona; and
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Aditya J. Desai
1Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Scottsdale, Arizona
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Hassan Siddiki
2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona; and
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Ba D. Nguyen
3Division of Nuclear Medicine, Department of Diagnostic Radiology, Mayo Clinic, Scottsdale, Arizona
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Abstract

Cholecystokinin cholescintigraphy is used clinically to quantify gallbladder ejection fraction as an indicator of functional gallbladder disorder. It can also provide the opportunity to quantify an individual’s responsiveness to the physiologic stimulant of gallbladder contraction, cholecystokinin, which is a major regulator of appetite and postprandial satiety. Methods: In the current work, we use cholecystokinin cholescintigraphy to quantify the kinetics of gallbladder emptying, including average and peak rates, in response to a standard cholecystokinin infusion. Results: We demonstrated that patients with no gallstones or biliary obstruction who empty their gallbladders completely in response to cholecystokinin, having an ejection fraction greater than 80%, exhibit a broad range of sensitivity to this hormone. Three distinct kinetic profiles were observed, with those most sensitive to cholecystokinin achieving the earliest peak and the fastest rate of gallbladder emptying, whereas those least sensitive to cholecystokinin have the latest peak and the slowest rate of emptying. Conclusion: Patients can have abnormal cholecystokinin stimulus–activity coupling as an effect of endogenous negative allosteric modulation by membrane cholesterol. This was predicted in ex vivo studies but has not, to our knowledge, previously been demonstrated in vivo. This type of kinetic analysis provides a tool to quantify cholecystokinin responsiveness in patients and identify patients who might benefit from a drug that would positively modulate cholecystokinin action to improve their appetite regulation and to better control their weight.

  • cholecystokinin
  • gallbladder
  • cholecystokinin cholescintigraphy
  • kinetics of gallbladder emptying
  • human gallbladder emptying

Footnotes

  • Published online Oct. 11, 2019.

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Journal of Nuclear Medicine Technology: 48 (1)
Journal of Nuclear Medicine Technology
Vol. 48, Issue 1
March 1, 2020
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Kinetics of Gallbladder Emptying During Cholecystokinin Cholescintigraphy as an Indicator of In Vivo Hormonal Sensitivity
Laurence J. Miller, Kaleeckal G. Harikumar, Aditya J. Desai, Hassan Siddiki, Ba D. Nguyen
Journal of Nuclear Medicine Technology Mar 2020, 48 (1) 40-45; DOI: 10.2967/jnmt.119.233486

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Kinetics of Gallbladder Emptying During Cholecystokinin Cholescintigraphy as an Indicator of In Vivo Hormonal Sensitivity
Laurence J. Miller, Kaleeckal G. Harikumar, Aditya J. Desai, Hassan Siddiki, Ba D. Nguyen
Journal of Nuclear Medicine Technology Mar 2020, 48 (1) 40-45; DOI: 10.2967/jnmt.119.233486
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Keywords

  • cholecystokinin
  • gallbladder
  • cholecystokinin cholescintigraphy
  • kinetics of gallbladder emptying
  • human gallbladder emptying
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