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Validation of the Lactose-[¹³C]Ureide Breath Test for Determination of Orocecal Transit Time by Scintigraphy

Center for Gastrointestinal Research, KU Leuven
Department of Nuclear Medicine, UZ Gasthuisberg, Leuven, Belgium

Correspondence: For correspondence or reprints contact: Benny Geypens, MSc, Lab Digestie-Absorptie, UZ Gasthuisberg E462, B - 3000 Leuven, Belgium.

ABSTRACT

The breath test using oral administration of a ¹³C-labeled substrate, lactose-ureide (LU), to measure orocecal transit time (OCTT) was validated against ^99mTc-scintigraphy. Although LU is not absorbed in the human small intestine, colonic bacteria readily metabolize LU, producing ¹³C-labeled CO₂. The time at which ¹³CO₂ appears in breath corresponds to the OCTT. Methods: Twenty-two healthy volunteers ingested a meal labeled with ^99mTc and ¹³C-LU. Scintigraphy was performed over 8 h at time intervals of 10 or 15 mm. OCTT with scintigraphy was defined as the time at which at least 10% of the label had entered the colon. Breath samples were obtained every 10–15 min for 10 h and measured by isotope ratio mass spectrometry. OCTT was defined as the time of first significant increase above baseline. The results were compared using correlation and Altman-Bland statistics. Results: OCTT results from scintigraphy (mean OCTT = 283 ± 53 m)andbreathtest(meanOCTT= 292± 58 min) correlated well (r = 0.94). Altman-Bland statistics showed close agreement between scintigraphy and breath test. No significant difference between male and female subjects was observed. Conclusion: The breath test using ¹³C-LU is a valid alternative to scintigraphy techniques for measuring OCTT.

Key Words: orocecal transit • ¹³C breath test • ^99mTc-scintigraphy

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