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Comparison of Fatty Meal and Intravenous Cholecystokinin Infusion for Gallbladder Ejection Fraction

¹ Nuclear Medicine Department, Tuality Community Hospital, Hillsboro, Oregon
² Diagnostic Radiology, Oregon Health and Science University, Portland, Oregon

Gallbladder ejection fraction (GBEF) measured with a fatty meal (half-and-half milk) was compared with that measured with 2 equal sequential intravenous infusions of cholecystokinin (CCK-8) in a paired study of healthy subjects. Methods: GBEF was measured by ^99mTc-hepatic iminodiacetic acid cholescintigraphy in 13 healthy subjects. Each subject received 2 sequential doses of CCK-8 (3 ng/kg/min for 10 min) on day 1, followed by, on day 2, a 240-mL (8 oz) fatty meal (half-and-half milk) per 70 kg of body weight. Results: The mean ± SD GBEF of 53.6% ± 20.2% with fatty meal was significantly lower than the mean of 75.8% ± 16.3% (P < 0.01) with the first dose of CCK-8 and 71.3% ± 17.4% (P < 0.05) with the second dose. Fatty meal GBEF varied widely, from 23.5% to 91.8%. Percentile rankings of the fatty meal GBEF were determined as the preferred methodology for reporting results. Latent and ejection periods were significantly longer with fatty meal than with either dose of CCK-8. Conclusion: GBEF measured with fatty meal can serve as an alternative method to intravenous injection of CCK-8 when the hormone is no longer available for clinical use. The measurement of GBEF with fatty meal requires careful attention to the details of the meal and the measurement time sequence.

Key Words: gallbladder ejection fraction • hepatobiliary imaging • cholecystokinin • fatty meal

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