TY - JOUR T1 - Comprehensive Radionuclide Esophagogastrointestinal Transit Study: Methodology, Reference Values, and Initial Clinical Experience JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 721 LP - 727 DO - 10.2967/jnumed.114.152074 VL - 56 IS - 5 AU - Alexander J. Antoniou AU - Shreya Raja AU - Riham El-Khouli AU - Esther Mena AU - Martin A. Lodge AU - Richard L. Wahl AU - John O. Clarke AU - Pankaj Pasricha AU - Harvey A. Ziessman Y1 - 2015/05/01 UR - http://jnm.snmjournals.org/content/56/5/721.abstract N2 - A radionuclide methodology and reference values have been developed for a single gastrointestinal transit study including esophageal transit, liquid and solid gastric emptying, and small- and large-bowel transit, using 111In-diethylenetriaminepentaacetic acid (DTPA) with the standardized 99mTc-labeled solid meal. Methods: Eighteen healthy subjects and 18 patients were investigated. The esophageal transit study was performed with 3.7 MBq (0.1 mCi) of 111In-DTPA in 15 mL of water. A liquid-only 30-min gastric-emptying study followed, with ingestion of 3.7 MBq (0.1 mCi) of 111In-DTPA in 300 mL of water. Then, a simultaneous solid–liquid emptying study was acquired after ingestion of a solid 99mTc-sulfur colloid–labeled meal and 7.4 MBq (0.2 mCi) of 111In-DTPA in 120 mL of water. Images were acquired intermittently for 4 h. Additional 111In images were acquired at 5 and 6 h to measure small-bowel transit, and at 24, 48, and 72 h for large-bowel transit. Results: Reference values were determined for esophageal transit (transit time, percentage emptying at 10 s), liquid-only gastric emptying (emptying half-time), liquid and solid emptying in a dual-phase solid–liquid study (emptying half-time and percentage emptying at 1, 2, 3, and 4 h), small-bowel transit index (percentage transit to ileocecal valve at 6 h), and colonic transit (geometric center and percentage colonic emptying) at 24, 48, and 72 h. Results from the first 18 patients found abnormal transit in 72% (13/18); clinical management changed in 61% (11/18). Conclusion: We have developed a radionuclide methodology and derived reference values for a comprehensive gastrointestinal transit study using 111In-DTPA with the standardized 99mTc-labeled solid meal. Our initial clinical experience suggests clinical value. ER -