Luna Cibele, Palacio Laura, Samaan Sam
Department of Radiology, Division of Abdominal Imaging, University of Miami, Jackson Memorial Hospital, Miami, FL.
Department of Radiology, Division of Nuclear Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL.
Medicine (Baltimore). 2025 Apr 25;104(17):e42246. doi: 10.1097/MD.0000000000042246.
This study aimed to evaluate the diagnostic utility of the 30- and 60-minute imaging time points for rapid gastric emptying (RGE) using gastric emptying scintigraphy. The primary objective was to determine whether the 30-minute time point, unique to the Miami Method, provides additional diagnostic value compared to the standard 60-minute time point recommended by the National Standard Protocol. A retrospective analysis was conducted on consecutive patients who underwent gastric emptying scintigraphy between 2015 and 2021. Patients were included if they completed imaging at both 30 and 60 minutes using a hybrid protocol incorporating the Miami Method and the National Standard Protocol. The McNemar's test was used to compare the frequency of RGE diagnosis at the 30- and 60-minute time points and Cohen's Kappa coefficient to assess the inter-time point agreement. Among the 38 patients diagnosed with RGE, 24 patients (63%) were diagnosed with RGE only at 30 minutes, 6 patients (16%) were diagnosed with RGE only at 60 minutes, and 8 patients (21%) were diagnosed with RGE at both 30 and 60 minutes. The McNemar's test showed a statistically significant difference (P = .0024) between the 30- and 60-minute time points, indicating that 30-minute imaging identifies a distinct group of patients who might not be diagnosed at 60 minutes. However, there was poor agreement between the 2 time points (Cohen's Kappa = -0.34), suggesting that the 30-minute time point may need further validation. The 30-minute imaging time point detected more cases of RGE compared to the 60-minute time point, suggesting that it may capture early rapid emptying events missed at 60 minutes. However, the lack of agreement between the time points raises concerns about overdiagnosis. These findings highlight the need for further research to validate the clinical utility of the 30-minute time point and determine its impact on patient management and outcomes.
本研究旨在利用胃排空闪烁扫描评估30分钟和60分钟成像时间点对快速胃排空(RGE)的诊断效用。主要目的是确定迈阿密方法特有的30分钟时间点与国家标准方案推荐的标准60分钟时间点相比是否具有额外的诊断价值。对2015年至2021年间连续接受胃排空闪烁扫描的患者进行了回顾性分析。如果患者使用结合了迈阿密方法和国家标准方案的混合方案在30分钟和60分钟均完成成像,则纳入研究。采用McNemar检验比较30分钟和60分钟时间点RGE诊断的频率,并使用Cohen's Kappa系数评估时间点之间的一致性。在38例被诊断为RGE的患者中,24例(63%)仅在30分钟时被诊断为RGE,6例(16%)仅在60分钟时被诊断为RGE,8例(21%)在30分钟和60分钟时均被诊断为RGE。McNemar检验显示30分钟和60分钟时间点之间存在统计学显著差异(P = 0.0024),表明30分钟成像可识别出一组在60分钟时可能未被诊断的不同患者群体。然而,两个时间点之间的一致性较差(Cohen's Kappa = -0.34),这表明30分钟时间点可能需要进一步验证。与60分钟时间点相比,30分钟成像时间点检测到更多RGE病例,这表明它可能捕捉到60分钟时遗漏的早期快速排空事件。然而,时间点之间缺乏一致性引发了对过度诊断的担忧。这些发现凸显了进一步研究以验证30分钟时间点的临床效用并确定其对患者管理和结局的影响的必要性。