☢️ Scintigrafie de Evacuare Gastrică pentru Solide (Gastric Emptying)

Updated Gastric Emptying (Solid-Phase) Scan 9/8/2024 ●Indications To assess gastric emptying.  ●Radiopharmaceutical: 1.0 mCi Tc-99m sulfur colloid in egg meal by mouth (use oatmeal meal if the patient allergic to eggs or is vegan) ●Meal Option 1 - Egg meal consists of 4 oz liquid egg whites, two slices of toasted white bread, 30 grams jam/jelly and 4 oz water.  Option 2 - Oatmeal meal consists of 1 oz plain instant oatmeal mixed with 4 oz water and 1 sugar packet. 10 oz water is also consumed. The meal should be consumed in under 10 mins. ●Patient Preparation: The patient needs to be NPO for 4 hrs (minimal) to 12 hrs (preferable) prior to the exam.  The patient should avoid prokinetic medications that increase gastric emptying speed for 2 days - metoclopramide (Reglan), erythromycin, tegaserod (Zelnorm), cisapride and domperidone (Motilium).  The patient should avoid medications that slow gastric emptying for 2 days - opiates, antispasmodic agents, nifedipine (Procardia), progesterone, octreotide (Sandostatin), theophylline, benzodiazepines and phentolamine. ●Conflicting Examinations/Medications: No Nuclear Medicine exams within the previous 24 hrs. No barium GI exams within the previous 48 hrs. ●Pregnancy/Lactation:  Pregnancy testing is only needed in potentially pregnant patients who state they could be pregnant. See Pregnant, Potentially Pregnant and Lactating Patients policy for specifics. Breast feeding mothers should discard breast milk for 4-24 hrs following Tc-99m sulfur colloid administration. ●Imaging Technique: Collimator - LEHR or LEAP Photopeak - 140 keV 20% window for Tc-99m Image Preset Counts - 60 secs/image Matrix Size - 128 x 128 Patient Positioning - supine ●Imaging Views: Begin imaging as soon as the patient finishes ingesting the radionuclide/meal. Simultaneous anterior and posterior imaging with the calculated geometric mean is preferred over anterior-only imaging.  Obtain images at 0 mins, 30 mins, 1 hr, 2 hrs, 3 hrs and 4 hrs. Imaging can be stopped once the percent remaining in the stomach drops below 10%. ●Notes: Normal gastric retention percents: ◦30 mins - >70% retained ◦60 mins - 30-90% retained ◦2 hrs - <60% retained ◦3 hrs - <30% retained ◦4 hrs - <10% retained Retention of more than 10% of the meal in the stomach at 4 hrs is abnormal and is the best discriminator between normal and abnormal gastric emptying.