Simultaneous 13 C/ 14 C dual isotope breath test measurement of gastric emptying of solid and liquid in normal subjects and patients: comparison with scintigraphy

摘要

BACKGROUND: To develop a simple method for simultaneous solid and liquid gastric emptying assessment using a dual isotope labelled breath test. MATERIAL AND METHODS: 13 patients were given 100 g ground beef labelled with 25 MBq 99m Tc sulphur colloid and 74 KBq 14 C octanoic acid, and 150 ml 10% glucose drink labelled with 8 MBq 67 Ga citrate and 150 mg 13 C acetate. 10 normal volunteers were given the same test meals but labelled with 14 C and 13 C only. Breath was collected at baseline and regularly for 4 hours. The 14 CO 2 and 13 CO 2 activity was measured with liquid scintillation counting and mass spectroscopy. The times to maximum 14 CO 2 and 13 CO 2 , were determined. Comparison was made between times to maximum 14 CO 2 with scintigraphic retention of 99m Tc at 100 minutes and times to maximum 13 CO 2 with the scintigraphic half-clearance time of 67 Ga. RESULTS: For the solid meal, the times to maximum 14 CO 2 were: 60–120 minutes in the 8 patients with normal gastric emptying of 99m Tc; 75–145 minutes for the 10 healthy volunteers; 75–180 minutes for the remaining 5 patients with abnormal gastric emptying of 99m Tc. There was a weak but significant correlation (r = 0.56, p 14 CO 2 and gastric retention of 99m Tc at 100 minutes. For the liquid meal, times to maximum 13 CO 2 were: 20–35 minutes for the 4 with normal gastric emptying of 67 Ga; 15–40 minutes for the 10 healthy volunteers; 20–75 minutes for the remaining 9 patients with abnormal gastric emptying of 67 Ga. There was a strong and significant correlation (r = 0.88, p 13 CO 2 and gastric half-clearance time of 67 Ga. CONCLUSIONS: Breath tests utilising test meals labelled with *C isotopes are valid alternatives to scintigraphic studies using 99m Tc and 67 Ga for the simultaneous assessment of gastric emptying of solids and liquids.