A New Normal. Evaluating normal values for functional gallbladder imaging with the use of fatty meal substitute for ejection fraction

Objectives: Evaluate test performance of functional cholescintigraphy with oral fatty meal supplement versus IV sincalide.

Methods: Retrospective analysis of approximately 1,174 cholescintigraphy examinations which utilized an oral fatty meal supplement. Further, the data set was also analyzed to evaluate for potential differences in gall-bladder ejection fractions based on age and sex. These findings were compared to a similarly sized sample of 20 minute infusion IV CCK cholescintigraphic studies to compare and contrast differences in test performance.

Results: Histogram of the oral fatty meal supplemented cholescintigraphy shows a left skewed distribution with a mean of 67.13, median of 72, mode of 81 and standard deviation of 45.6. No significant differences in results were noted when data was analyzed with respect to age and sex. Given that past analysis of gallbladder ejection fractions has always yielded non-Gaussian, near-random distributions, quartile analysis has been the mainstay for establishing normal values, typically with a cut-off of 35%.

Conclusion: This data set suggests that using oral fatty meal supplement in place of IV CCK could yield a more normalized distribution of results.

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