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.