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Title: Gastric emptying scintigraphy results in children are affected by age, anthropometric factors, and study duration

item WONG, G - Baylor College Of Medicine
item SHULMAN, R - Children'S Nutrition Research Center (CNRC)
item CHUMPITAZI, B - Texas Children'S Hospital

Submitted to: Neurogastroenterology & Motility
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/25/2014
Publication Date: 3/1/2015
Publication URL:
Citation: Wong, G.K., Shulman, R.J., Chumpitazi, B.P. 2015. Gastric emptying scintigraphy results in children are affected by age, anthropometric factors, and study duration. Neurogastroenterology & Motility. 27(3):356-362.

Interpretive Summary: A common test to measure how well the stomach is working is called gastric emptying scintigraphy (GES). Although this test is often used in children, we do not know what factors affect the results. In this study we learned that the age of the children and their size have a profound effect on the results. Thus, these factors must be accounted for in order to interpret the test results correctly. We also learned that the test must be carried out over 4 hours to be most accurate. Such findigs should be considered when performing similiar tests in the future.

Technical Abstract: A standardized 4-hour adult-based gastric emptying scintigraphy (GES) protocol is increasingly being used in children to evaluate for gastroparesis. We sought to determine the effect of age, anthropometrics, and study duration on GES results using this protocol in children. Retrospective review of children who underwent a 4-hour solid-meal GES study at a tertiary care center. GES results and anthropometric data (e.g., weight, stature, body surface area [BSA]) were systematically captured. Of 216 children, 188 (87%) were able to complete the study meal. Children unable to complete the meal were younger and smaller. In multivariate analysis, only increasing BSA was identified as being positively associated with ability to complete the meal (odds ratio: 19.7; p < 0.001). Of those completing the meal, 48 (26%) had delayed emptying (4-h retention value >10%). These children were significantly younger and smaller than those with normal emptying. In multivariate analysis of those completing the meal, only increasing BSA (odds ratio: 0.26; p = 0.006) was identified as being negatively associated with delayed emptying. There was a progressive increase in the positive predictive value for identification of delayed gastric emptying as the duration of the study increased (0.25, 0.60, and 0.71 at 1, 2, and 3 h, respectively) using the 4-hr value as a comparator. Young children have more difficulty completing the GES meal. Childhood gastric retention is affected by age and anthropometric factors, primarily BSA. The standardized 4-h GES protocol may need to take these factors into account in children.