Variability of gastric emptying time using standardized radiolabeled meals

To define the range of inter- and intra-subject variability on gastric emptying measurements, eight healthy male subjects (ages 19-40) received meals on four separate occasions. The meal consisted of 150 g of beef stew labeled with Tc-99m SC labeled liver (600 μCi) and 150 g of orange juice containing In-111 DTPA (100 μCi) as the solid- and liquid-phase markers respectively. Images of the solid and liquid phases were obtained at 20 min intervals immediately after meal ingestion. The stomach region was selected from digital images and data were corrected for radionuclide interference, radioactive decay and the geometric mean of anterior and posterior counts. More absolute variability was seen with the solid than the liquid marker emptying for the group. The mean solid half-emptying time was 58 +- 17 min (range 29-92) while the mean liquid half-emptying time was 24 +- 8 min (range 12-37). A nested random effects analysis of variance showed moderate intra-subject variability for solid half-emptying times (rho = 0.4594), and high intra-subject variability was implied by a low correlation (rho = 0.2084) for liquid half-emptying. The average inter-subject differences were 58.3% of the total variance for solids (rho = 0.0017). For liquids, the inter-subject variability was 69.1% of the total variance, but was only suggestive of statistical significance (rho = 0.0666). The normal half emptying time for gastric emptying of liquids and solids is a variable phenomenon in healthy subjects and has great inter- and intra-individual day-to-day differences