Combined Gastric Alimetry® and gastric emptying scintigraphy testing increases clinician certainty in the diagnosis and management of suspected gastroparesis
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Background and Aim
Gastric emptying scintigraphy (GES) is the reference standard test for diagnosing gastroparesis. Body surface gastric mapping (BSGM) via Gastric Alimetry® is a new test of gastric function that combines non-invasive assessment of gastric electrophysiology and validated symptom profiling. This randomized, prospective pilot study evaluated the impact of GES vs BSGM test results on clinical decision-making.
Methods
Patients with chronic gastroduodenal symptoms from a tertiary center referred for GES were recruited. Subjects separately underwent baseline assessment with GES and BSGM testing. Two motility-specialists were first asked to devise a management plan after reviewing a test result (GES or BSGM, in random order). They were then asked to repeat the management plan after reviewing the other test result (BSGM or GES). Clinician-perceived certainty measures were assessed.
Results
Sixteen patients, 13 (81%) female, median age 30 years, median BMI 22.5 kg/m 2 , were recruited. At baseline, a diagnosis was established in 2/16 (12.5%) and increased to 8/16 (50%) with both tests. Abnormal test results were found in 11 patients. In patients with normal results, BSGM symptom profiling phenotyped 5 additional patients. All patients received an intervention following the first unblinding, with subsequent management changes made in 75% (BSGM) and 62.5% (GES) of patients. The combined GES and BSGM results significantly increased diagnostic and management certainty (p<0.05), with both tests having similar influence on management (p>0.05).
Conclusion
The combined GES and BSGM test results significantly enhanced diagnostic and management confidence in patients with suspected gastroparesis within a tertiary center.
