NuclearMedicineGuidelinesCommunicationsBritish Nuclear Medicine Society Clinical Guidelines forGastric emptyAlp Notghi,Gregory James and Peter D.HayNuclear Medicine Communications 2023,44:563-570Correspondence to Alp Notghi,Department of Physics and Nuclear Medicine,Consultant Physician in Nuclear Medicine,Sandwell and West Birmingham NHSDepartment of Physics and Nuclear Medicine,Consultant Physician in NuclearTrust,City Hospital,Dudley Road,Birmingham B18 7QH,UKMedicine,Sandwell and West Birmingham NHS Trust,Birmingham,Head ofE-mail:alp.notghi@nhs.netNuclear Medicine Physics,Royal Stoke University Hospital,University Hospitalsof North Midlands NHS Trust,Staffordshire andMedicalPhysics and ClinicalReceived 14 December 2022 Accepted 28 March 2023.Engineering,Nottingham University Hospitals NHS Trust,Nottingham,UKPurposeSeveral drugs alter the rate of emptying [3]so a historyThe purpose of this guideline is to assist specialists inof relevant medication should be taken prior to the testnuclear medicine and radionuclide radiology in recom-(which include prokinetic drugs such as erythromycinmending,performing,interpreting and reporting theand metoclopramide and drugs slowing gastric empty-results of gastric emptying studies.This guideline willing such as opiates and antispasmodics,see Appendixassist individual departments to formulate their own localA).Where possible,drugs that affect the emptying rateprotocols.This does not aim to be prescriptive regard-should be stopped for at least four phammaceutical half-ing technical aspects of individual camera acquisitions,lives prior to the test;however,this may not be possiblewhich need to be developed in conjunction with the localor advisable and should be tailored to the individ-Medical Physics Expert.These guidelines pertain only toual clinical context in consultation with the referringadult patients.clinician.BackgroundThe wide range of procedures used and the variabilityof gastric emptying make it essential that standard,vali-Gastric emptying scintigraphy is a safe,non-invasivedated methods are applied [5].For departments wishingmethod for assessing the ability of the stomach to emptyto set up this study,the standard consensus meal used inwhich has been used clinically for many years [1,21.It isthe USA (Procedure guideline for adult solid meal gastricregarded as a'gold standard'to assess gastric function andemptying study-Society of Nuclear Medicine guide-emptying of both solids and liquids allowing assessmentlines)is one option [6]as there is much experience withof early,mid and late emptying,each of which may bethis method and it is relatively straightforward althoughaltered by pathology.the meal may not be suitable for all patients.This stand-The normal stomach serves as a temporary storage areaard consensus meal and its normal range are validated forfor food.It physically and chemically breaks down foodthe simplified method;where a standard egg-based mealinto smaller particles via muscular activity
