Development and validation of a large, modular test meal with liquid and solid components for assessment of gastric motor and sensory function by non-invasive imaging

Parker, H.L. and Tucker, E. and Hoad, Caroline and Pal, A. and Costigan, C. and Hudders, N. and Perkins, A. and Blackshaw, E. and Gowland, P. and Marciani, L. and Fox, M.R. (2016) Development and validation of a large, modular test meal with liquid and solid components for assessment of gastric motor and sensory function by non-invasive imaging. Neurogastroenterology & Motility, 28 (4). pp. 554-568. ISSN 1350-1925

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Abstract

Background: Current investigations of stomach function are based on small test meals that do not reliably induce symptoms and analysis techniques that rarely detect clinically relevant dysfunction. This study introduces the large ‘Nottingham Test Meal’ (NTM) for assessment of gastric motor and sensory function by non-invasive imaging. Methods NTM comprises 400 mL liquid nutrient (0.75 kcal/mL) and 12 solid agar-beads (0 kcal) with known breaking strength. Gastric fullness and dyspeptic sensations were documented by 100 mm visual analogue scale (VAS). Gastric emptying (GE) were measured in 24 healthy volunteers (HVs) by gastric scintigraphy (GS) and magnetic resonance imaging (MRI). The contribution of secretion to gastric volume was assessed. Parameters that describe GE were calculated from validated models. Inter-observer agreement and reproducibility were assessed.

Key Results: NTM produced moderate fullness (VAS ≥30) but no more than mild dyspeptic symptoms (VAS <30) in 24 HVs. Stable binding of meal components to labels in gastric conditions was confirmed. Distinct early and late-phase GE were detected by both modalities. Liquid GE half-time was median 49 (95% CI: 36–62) min and 68 (57–71) min for GS and MRI, respectively. Differences between GS and MRI measurements were explained by the contribution of gastric secretion. Breaking strength for agar-beads was 0.8 N/m such that median 25 (8–50) % intact agar-beads and 65 (47–74) % solid material remained at 120 min on MRI and GS, respectively. Good reproducibility for liquid GE parameters was present and GE was not altered by agar-beads.

Conclusions & Inferences: The NTM provided an objective assessment of gastric motor and sensory function. The results were reproducible and liquid emptying was not affected by non-nutrient agar-beads. The method is potentially suitable for clinical practice.

Item Type: Article
Keywords: Gastric emptying, magnetic resonance imaging, scintigraphy, visceral sensitivity.
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Units > Radiology and Imaging Sciences
Identification Number: 10.1111/nmo.12752
Depositing User: Eprints, Support
Date Deposited: 12 May 2017 10:24
Last Modified: 13 Oct 2017 00:39
URI: http://eprints.nottingham.ac.uk/id/eprint/42810

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