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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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  • FIGURE 1.
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    FIGURE 1.

    Distribution of ejection fraction and kinetic parameters of cholecystokinin-stimulated gallbladder emptying in entire patient population. Bars reflect numbers of subjects in each bin, representing sequential 10% of total gallbladder emptying. Shown are conventional measure of gallbladder ejection fraction and key kinetic parameters of average rate over complete period of gallbladder emptying, peak rate of gallbladder emptying achieved, and average rate of gallbladder emptying over first 20 min of cholecystokinin infusion. GB = gallbladder.

  • FIGURE 2.
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    FIGURE 2.

    Relationships between gallbladder ejection fraction and kinetic parameters of cholecystokinin-stimulated gallbladder emptying in individuals. Shown are distributions of points representing individual data on left, and distributions of kinetic parameters in patients having gallbladder ejection fractions of at least 80%. In this select group with no demonstrable gallbladder or biliary pathology, there are wide distributions of kinetics, reflecting differences in cholecystokinin responsiveness. EF = ejection fraction; GB = gallbladder.

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    FIGURE 3.

    Kinetic profiles observed in patients with cholecystokinin-stimulated gallbladder ejection fractions of at least 80%. Profile 1, with earliest peak response, exhibited highest rate of emptying and highest average rate of emptying. Profile 3, with latest peak response, exhibited lowest peak rate and lowest average rate of emptying. Representative profiles are shown. GB = gallbladder.

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    TABLE 1

    Characteristics of Study Population and Subgroup Exhibiting Complete Gallbladder Emptying

    Overall populationEjection fraction ≥ 80%
    CharacteristicTotalMaleFemaleTotalMaleFemale
    Age (y)52.8 ± 15.5 (238)54.0 ± 15.4 (80)52.2 ± 15.6 (158)53.2 ± 15.5 (141)55.4 ± 15.8 (50)52 ± 15.2 (91)
    Male (n)8080050500
    Female (n)158015891091
    Weight (kg)77.4 ± 20.8 (233)91.9 ± 20.7 (77)70.2 ± 16.8 (156)76.8 ± 19.9 (140)89.1 ± 21.3 (50)70 ± 15.3 (90)
    Body mass index (kg/m2)27.1 ± 6.0 (230)29.0 ± 5.7 (77)26.2 ± 5.9 (153)26.9 ± 6.0 (137)28.4 ± 6.3 (50)26.1 ± 5.7 (87)
    Fasting glucose (mg/dL)99.3 ± 21.2 (200)104.4 ± 26.4 (64)96.9 ± 17.9 (136)97.8 ± 17.7 (116)101 ± 19 (25)96.3 ± 16.9 ()
    Serum cholesterol (mg/dL)189.3 ± 36.5 (120)179.1 ± 35.7 (42)194.8 ± 36.0 (78)190.4 ± 33.3 (68)181.4 ± 36.7 (25)195.6 ± 30.4 (43)
    LDL cholesterol (mg/dL)106 ± 31.4 (109)101.1 ± 30.4 (36)107.6 ± 31.9 (73)106.1 ± 27.6 (62)100.6 ± 31.7 (21)108.9 ± 25.2 (41)
    HDL cholesterol (mg/dL)59.8 ± 19.4 (120)50.5 ± 13.8 (42)64.9 ± 20.1 (78)61.2 ± 19.7 (68)53.1 ± 13.9 (25)65.8 ± 21.1 (43)
    Triglycerides (mg/dL)124.5 ± 71.7 (121)147.9 ± 84.7 (42)112 ± 60.7 (79)117.5 ± 74.6 (68)145.5 ± 94.4 (25)101.3 ± 55.2 (43)
    Systolic blood pressure (mm Hg)124.1 ± 17.4 (220)128.3 ± 16.6 (71)122 ± 17.4 (149)123.6 ± 17.2 (131)126.5 ± 17.5 (44)122 ± 16.9 (87)
    Diastolic blood pressure (mm Hg)74.8 ± 9.5 (220)76.5 ± 9.9 (71)73.9 ± 9.2 (149)75.1 ± 9.5 (131)76.2 ± 9.7 (44)74.5 ± 9.4 (87)
    • Values are expressed as mean ± SD, with n in parentheses.

    • HDL = high-density lipoprotein; LDL = low-density lipoprotein.

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    TABLE 2

    Characteristics of Subjects with Extremes of Body Mass Index in Group with Complete Gallbladder Emptying

    TotalMaleFemale
    CharacteristicUpper 20%Lower 20%Upper 20%Lower 20%Upper 20%Lower 20%
    Body mass index36.3 ± 6.0 (24)20.1 ± 1.9* (28)36.5 ± 8.0 (11)20.5 ± 1.6* (6)36.1 ± 4.2 (13)19.9 ± 2.0* (22)
    Age (y)56.5 ± 15.0 (28)50.5 ± 15.6 (28)54.8 ± 17.6 (11)54.7 ± 18.7 (6)57.5 ± 13.6 (17)49.4 ± 14.9 (22)
    Male (n)11611600
    Female (n)1722001722
    Weight (kg)99.4 ± 24.5 (27)56.6 ± 8.2* (28)114.6 ± 27.3 (11)63.7 ± 7.0* (6)88.0 ± 16.0 (16)54.6 ± 7.5* (22)
    Fasting glucose (mg/dL)104.1 ± 21.1 (18)98.8 ± 20.7 (28)112.9 ± 30.6 (7)100.3 ± 18.2 (6)98.5 ± 10.4 (11)98.4 ± 21.7 (22)
    Serum cholesterol (mg/dL)181.3 ± 16.5 (11)192.4 ± 36.7 (16)172.3 ± 18.5 (4)135.5 ± 0.7 (2)186.4 ± 14.1 (7)200.5 ± 31.4 (14)
    LDL cholesterol (mg/dL)100.6 ± 20.5 (10)104.8 ± 30.8 (15)90.3 ± 17.9 (4)72.0 ± 2.8 (2)107.5 ± 20.6 (6)109.8 ± 30.0 (13)
    HDL cholesterol (mg/dL)53.4 ± 9.5 (11)71 ± 20.5* (16)53 ± 10 (4)50.5 ± 7.8 (2)53.6 ± 10.0 (7)73.9 ± 20.1* (14)
    Triglycerides (mg/dL)119.1 ± 44.7 (11)81.1 ± 32.7* (16)137.5 ± 59.5 (4)66.5 ± 21.9 (2)108.5 ± 34.8 (7)83.1 ± 34.0* (14)
    Systolic blood pressure (mm Hg)132 ± 17.6 (25)114.2 ± 13.1* (28)131.8 ± 19.6 (10)115.2 ± 11.3 (6)132.1 ± 16.8 (15)113.9 ± 13.8* (22)
    Diastolic blood pressure (mm Hg)78.7 ± 6.5 (25)68.8 ± 8.4* (28)77.4 ± 7.1 (10)72.5 ± 10.2 (6)79.6 ± 6.2 (15)67.8 ± 7.7* (22)
    • ↵* P ≤ 0.05, comparing values for upper and lower quintiles for each parameter.

    • HDL = high-density lipoprotein; LDL = low-density lipoprotein.

    • Values are expressed as mean ± SD, with n in parentheses.

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Journal of Nuclear Medicine Technology: 48 (1)
Journal of Nuclear Medicine Technology
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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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