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Year : 2015  |  Volume : 30  |  Issue : 4  |  Page : 303-308

Standardization of "In-House fatty meal" methodology for cholescintigraphy

1 Department of Nuclear Medicine and PET CT, Apollo Main Hospitals, Chennai, Tamil Nadu, India
2 Department of Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India
3 Department of Medical Education, Apollo Main Hospitals, Chennai, Tamil Nadu, India

Correspondence Address:
Avani S Jain
Department of Nuclear Medicine and PET CT, Apollo Main Hospital, No. 21, Greams Lane, Off. Greams Road, Chennai - 600 006, Tamil Nadu
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Source of Support: Nil., Conflict of Interest: There are no conflicts of interest.

DOI: 10.4103/0972-3919.164021

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Aim: This study was aimed at standardizing the "In-House fatty meal" methodology in cholescintigraphy and to determine gall bladder ejection fraction (GBEF) with this standardized meal. Materials and Methods: This is a prospective case–control study where 61 patients having right upper quadrant pain and postprandial bloating and 59 healthy volunteers were included. They underwent 99mTc-mebrofenin fatty meal cholescintigraphy following a standard protocol. Dynamic acquisitions over 120 min were done, with a fatty meal being given between 45- and 60-min. Gallbladder emptying kinetics was studied by assessing the time activity curves and calculation of GBEFs were made at 30-min, 45-min, and at 60-min and assessed. Results: The GBEF at 30-min was 74.42% ± 8.26% (mean ± standard deviation), at 45-min was 82.61% ± 6.5%, and at 60-min was 89.37% ± 4.48% in the volunteer group. The lower limit of GBEF in volunteers at 30-min was 58%, 45-min was 69%, and at 60-min was 81%. Receiver operating characteristic (ROC) analysis showed that 30-min GBEF provided the best separation between healthy and diseased subjects with an area under curve of 0.952 (95% confidence interval = 0.914–0.989). The lower limit of GBEF at 30-min was 58%. Conclusions: An in-House standard fatty meal could be a reproducible alternative to cholecystokinin as it is well-tolerated. Based on ROC curve analysis, we propose that 30-min GBEF provides good separation between healthy and diseased people with this in-House fatty meal. Hence, dynamic acquisitions beyond 30-min postingestion of the fatty meal may not be warranted.

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