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Research ArticleClinical Investigations

Multicenter Validation of a Shortened Gastric-Emptying Protocol

Matthieu Pelletier-Galarneau, Oyebola O. Sogbein, Xuan Pham, Jason Hao, Jenna Le, Mark D. Strober, Michael L. Middleton, Janusz Kikut, Leonard M. Freeman and Lionel S. Zuckier
Journal of Nuclear Medicine June 2015, 56 (6) 873-876; DOI: https://doi.org/10.2967/jnumed.115.155366
Matthieu Pelletier-Galarneau
1The Ottawa Hospital, Division of Nuclear Medicine, Ottawa, Ontario, Canada
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Oyebola O. Sogbein
1The Ottawa Hospital, Division of Nuclear Medicine, Ottawa, Ontario, Canada
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Xuan Pham
1The Ottawa Hospital, Division of Nuclear Medicine, Ottawa, Ontario, Canada
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Jason Hao
2University of Vermont Medical Center, Burlington, Vermont
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Jenna Le
3Montefiore Medical Center, Bronx, New York; and
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Mark D. Strober
4Baylor Scott & White Health, Central Texas, Temple, Texas
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Michael L. Middleton
4Baylor Scott & White Health, Central Texas, Temple, Texas
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Janusz Kikut
2University of Vermont Medical Center, Burlington, Vermont
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Leonard M. Freeman
3Montefiore Medical Center, Bronx, New York; and
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Lionel S. Zuckier
1The Ottawa Hospital, Division of Nuclear Medicine, Ottawa, Ontario, Canada
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  • FIGURE 1.
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    FIGURE 1.

    (A and B) Distribution of gastric retention values at 2 h (A) and 4 h (B) for all 431 participants. (C and D) Distribution of gastric retention values at 4 h for patients with gastric retention > 65% at 2 h (C) and < 45% at 2 h (D).

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    FIGURE 2.

    Scatterplot of 2-h vs. 4-h gastric retention values. Four-hour cutoff of 10% for delayed gastric emptying is illustrated by vertical dashed line. Bonta 2-h criteria for delayed (>65%) and normal (<45%) gastric retention are shown by horizontal dashed lines. False-positive results (2-h retention > 65%; 4-h retention ≤ 10%) correspond to shaded area at upper left, whereas false-negative results (2-h retention < 45%; 4-h retention > 10%) correspond to shaded area at lower right. GE = gastric emptying; MMC = Montefiore Medical Center; S&W =Baylor Scott & White Health; TOH = The Ottawa Hospital; UVM = University of Vermont Hospital.

  • FIGURE 3.
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    FIGURE 3.

    Receiver-operating-characteristic (ROC) curve for 2-h gastric retention for diagnosis of delayed 4-h gastric emptying. Sensitivity and specificity of Bonta criteria (●) are more accurate than any single 2-h cutoff. AUC = Area under curve.

Tables

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    TABLE 1

    Patient Characteristics for Each Center

    CenternWomen (n)Delayed 4-h emptying (n)
    Montefiore Medical Center13089 (68.5%)34 (26.2%)
    Baylor Scott & White Health10074 (74.0%)23 (23.0%)
    Ottawa Hospital10177 (76.2%)17 (16.8%)
    University of Vermont Hospital10066 (66.0%)31 (31.0%)
    Total431306 (71.0%)105 (24.4%)
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    TABLE 2

    Contingency Table of Shortened Bonta Protocol Compared with 4-Hour Retention

    Finding4 h > 10%4 h ≤ 10%Total
    Shortened protocol positive9710107
    Shortened protocol negative8316324
    Total105326431
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    TABLE 3

    Comparison of Current and Bonta-Based Results (6)

    ParameterMulticenterBonta original datasetBonta validation dataset
    n431174158
    Prevalence of delayed gastric emptying (%)24.426Not applicable
    Proportion of patients stopped at 2 h (%)74.97978
    Accuracy (%)95.896.694.9
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Journal of Nuclear Medicine: 56 (6)
Journal of Nuclear Medicine
Vol. 56, Issue 6
June 1, 2015
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Multicenter Validation of a Shortened Gastric-Emptying Protocol
Matthieu Pelletier-Galarneau, Oyebola O. Sogbein, Xuan Pham, Jason Hao, Jenna Le, Mark D. Strober, Michael L. Middleton, Janusz Kikut, Leonard M. Freeman, Lionel S. Zuckier
Journal of Nuclear Medicine Jun 2015, 56 (6) 873-876; DOI: 10.2967/jnumed.115.155366

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Multicenter Validation of a Shortened Gastric-Emptying Protocol
Matthieu Pelletier-Galarneau, Oyebola O. Sogbein, Xuan Pham, Jason Hao, Jenna Le, Mark D. Strober, Michael L. Middleton, Janusz Kikut, Leonard M. Freeman, Lionel S. Zuckier
Journal of Nuclear Medicine Jun 2015, 56 (6) 873-876; DOI: 10.2967/jnumed.115.155366
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Keywords

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