Issues Requiring Further Investigation for GES
| 1. Optimization of the specific time points used for imaging and interpretation: |
| A. Use of 0.5- or 1-h result for detection of rapid gastric emptying. |
| B. Use of 3-h result compared to 2- and 4-h results for detection of delayed GE. |
| C. Use of multiple time points (2- and 4-h) versus single 2- or 4-h values and further understanding of the clinical meaning of discordant results between 2- and 4-h scans. |
| 2. Need for normal data on other meals: |
| A. Use of different composition solid meals with different caloric/fat challenges. |
| B. Need for alternative meals for patients unable to tolerate eggs, allergic to eggs, or with gluten sensitive enteropathy. |
| 3. Need for glycemic control and management of diabetic patients: |
| A. Assessment of glucose in diabetic patients prior to the test: glucose and Hgb-A1c. |
| B. Management of hyperglycemic patients on the day of test. |
| C. Administration of insulin and oral hypoglycemic agents. |
| D. Need for monitoring postprandial glucose. |
| 4. Value of monitoring symptoms during the time of study. |
| 5. Development of a scale to assess severity of delayed gastric emptying. |
| 6. Need for database of “normal” values for postgastric surgery patients. |
| 7. Clinical value of characterization of proximal and distal gastric function: |
| A. Regional analysis of gastric emptying (separate antral and fundal measurements). |
| B. Dynamic antral contraction studies. |
| C. Fundal accommodation studies with SPECT. |
| 8. Other quantitative measurements: |
| A. Curve fitting. |
| B. Lag phase measurements. |
| C. Use of total abdominal counts. |
| 9. Industry software development: |
| A. Need for industry to develop commercial acquisition and processing protocols that support these consensus recommendations. |