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

Abstract

Background: A standardized 4-h 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.

Methods: Retrospective review of children who underwent a 4-h 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.

Key results: 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.

Conclusions & inferences: 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.

Keywords: children; dyspepsia; gastric emptying; gastroparesis; motility; nuclear medicine.

Conflict of interest statement

CONFLICTS OF INTEREST

The authors do not have conflicts of interest to report.

© 2015 John Wiley & Sons Ltd.

Figures

FIGURE. Gastric Retention Values over Time between Age- and Anthropometric-based Groups

Gastric retention values over time between children (n=188) when divided into quartiles by (A) age, (B) height, (C) body mass index, (D) weight, and (E) body surface area.