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Research ArticleImaging

Proximal and Distal Gastric Retention Patterns in Gastroparesis and the Impact of Gastric Per-Oral Endoscopic Myotomy: A Retrospective Analysis Using Gastric Emptying Scintigraphy

Robert Spandorfer, Yin Zhu, Mohamed M. Abdelfatah, Parit Mekaroonkamol, Sunil Dacha, James R. Galt, Raghuveer Halkar and Qiang Cai
Journal of Nuclear Medicine Technology June 2020, 48 (2) 158-162; DOI: https://doi.org/10.2967/jnmt.119.235630
Robert Spandorfer
1Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia; and
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Yin Zhu
1Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia; and
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Mohamed M. Abdelfatah
1Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia; and
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Parit Mekaroonkamol
1Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia; and
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Sunil Dacha
1Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia; and
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James R. Galt
2Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
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Raghuveer Halkar
2Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
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Qiang Cai
1Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia; and
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Abstract

Gastroparesis is a debilitating disease of insufficient gastric emptying and visceral hypersensitivity characterized by nausea, vomiting, early satiety, and bloating. Gastric emptying scintigraphy (GES), in combination with typical symptoms and normal esophagogastroduodenoscopy findings, is used to diagnose the disease. Gastric per-oral endoscopic pyloromyotomy (G-POEM) has emerged as a novel technique for treating gastroparesis, with up to an 80% success rate. This procedure involves myotomy of the distal stomach. We hypothesize that responders to this therapy are characterized by more distal dysmotility than nonresponders, as defined by GES retention patterns. Methods: We used regional gastric emptying measurements from diagnostic GES to determine the proximal or distal predominance of disease for each patient. We then compared treatment response and symptoms in each patient to total gastric half-emptying time (T½), proximal gastric T½, and a ratio comparing the 2 values. Results: In total, 47 patients underwent G-POEM during the study period. A significant difference (P < 0.01) was found in proximal-to-total T½ ratio between responders and nonresponders. A significant difference between pre- and postprocedural proximal-to-total T½ ratios was identified for each patient. No correlations were identified between motility patterns and symptoms or in motility patterns among the different etiologies of the disease. Conclusion: Proximal-to-total T½ ratio may represent an important patient selection factor for G-POEM versus other treatment modalities going forward. Local retention patterns in GES may not inform the symptom profile in gastroparesis.

  • GPOEM
  • POP
  • gastroparesis
  • gastric emptying scintigraphy

Footnotes

  • ↵* Contributed equally to this work.

  • Published online Dec. 6, 2019.

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Journal of Nuclear Medicine Technology: 48 (2)
Journal of Nuclear Medicine Technology
Vol. 48, Issue 2
June 1, 2020
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Proximal and Distal Gastric Retention Patterns in Gastroparesis and the Impact of Gastric Per-Oral Endoscopic Myotomy: A Retrospective Analysis Using Gastric Emptying Scintigraphy
Robert Spandorfer, Yin Zhu, Mohamed M. Abdelfatah, Parit Mekaroonkamol, Sunil Dacha, James R. Galt, Raghuveer Halkar, Qiang Cai
Journal of Nuclear Medicine Technology Jun 2020, 48 (2) 158-162; DOI: 10.2967/jnmt.119.235630

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Proximal and Distal Gastric Retention Patterns in Gastroparesis and the Impact of Gastric Per-Oral Endoscopic Myotomy: A Retrospective Analysis Using Gastric Emptying Scintigraphy
Robert Spandorfer, Yin Zhu, Mohamed M. Abdelfatah, Parit Mekaroonkamol, Sunil Dacha, James R. Galt, Raghuveer Halkar, Qiang Cai
Journal of Nuclear Medicine Technology Jun 2020, 48 (2) 158-162; DOI: 10.2967/jnmt.119.235630
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Keywords

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