Matthew Mitcheltree
Quality Improvement in Pediatric Gastric
Emptying Scintigraphy
SchoolRocky River High School • Rocky River, Ohio
ProgramScience Internship
MentorShyam Srinivas, MD, PhD
DepartmentNuclear Medicine, Cleveland Clinic
- Research
- Quality Improvement in Pediatric Gastric Emptying Scintigraphy
- Hypothesis
- Gastric emptying (GE) studies attempt to measure the rate at which a patient’s stomach empties its contents into the duodenum. However, pediatric gastric emptying studies often are performed with large variation in meal type and volume. It is hypothesized that current methods of assessment of pediatric gastric emptying are not optimal, due to lack of standardization of procedures and interpretation.
- Methodology
- We performed a retrospective analysis of data from GE/GER studies (January 2003 through June 2008), involving 575 children (ages 1 month to 18 years), and sorted by meal type (Water, n=89; Juice, n=170; Milk/Formula, n=316). Epic Hyperspace® enabled analysis of information on patients’ age, meal type, T½ value, meal volume, and clinical impression.
- Outcomes
- The current method of assessment for GE studies exhibited a less-than-optimal diagnosis accuracy of ≤65% for all meal types (27% for milk/formula category). We recommend the use of a standardized meal and meal volume, as well as the utilization of percent retention (%R) values, rather than currently-employed T½ quantification. We propose an improved protocol including meal and volume standardization based on age and tolerance, improvements on imaging procedure and generation of time-activity curves, and a system of interpretive criteria consistent with current medical literature.
Interpretations
A Minor Digestion by Haley Topp
Got Milk, In Your Stomach? by Bryana Arancibia
An Appetite for Health by Tabbitha Kilpatrick
