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Gastric motor and sensory function in health assessed by magnetic resonance imaging: Establishment of reference intervals for the Nottingham test meal in healthy subjects

Parker, Helen; Hoad, Caroline L.; Tucker, Emily; Costigan, Carolyn; Marciani, Luca; Gowland, Penny; Fox, Mark

Authors

Helen Parker

CAROLINE HOAD CAROLINE.L.HOAD@NOTTINGHAM.AC.UK
Senior Research Fellow

Emily Tucker

Carolyn Costigan

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LUCA MARCIANI LUCA.MARCIANI@NOTTINGHAM.AC.UK
Professor of Gastrointestinal Imaging

Mark Fox



Abstract

Background: Current investigations of gastric emptying rarely identify the cause of symptoms or provide a definitive diagnosis in patients with dyspepsia. This study assessed gastric function by magnetic resonance imaging (MRI) using the modular "Nottingham Test Meal" (NTM) in healthy volunteers (HVs).
Methods: The NTM comprises (i) 400mL liquid nutrient (0.75kcal/mL) labelled with Gadolinium DOTA and (ii) an optional solid component (12 agar-beads (0kcal)). Filling sensations were documented. MRI measurements of gastric volume, emptying, contraction wave frequency and secretion were obtained using validated methods.
Key Results: Gastric function was measured in a population of 73 HVs stratified for age and sex. NTM induced moderate satiety and fullness. Labelled fluid was observed in the small bowel in all subjects after meal ingestion ("early-phase" GE).
Secretion was rapid such that postprandial gastric content volume was often greater than meal volume (GCV0 >400ml) and there was increasing dilution of the meal during the study (p less than 0.001). Gastric half‐time was median 66‐minutes (95% reference interval 35 to 161‐minutes [“late‐phase” GE]). The number of intact agar beads in the stomach was 7/12 (58%) at 60‐minutes and 1/12 (8%) at 120‐minutes. Age, bodyweight and sex had measurable effects on gastric function; however, these were small compared to inter‐individual variation for most metrics.
Conclusions and Inferences: Reference intervals are presented for MRI measurements of gastric function assessed for the mixed liquid/solid NTM. Studies in patients will determine which metrics are of clinical value and also whether the reference intervals presented here offer optimal diagnostic sensitivity and specificity.

Citation

Parker, H., Hoad, C. L., Tucker, E., Costigan, C., Marciani, L., Gowland, P., & Fox, M. (2018). Gastric motor and sensory function in health assessed by magnetic resonance imaging: Establishment of reference intervals for the Nottingham test meal in healthy subjects. Neurogastroenterology and Motility, 30(12), Article e13463. https://doi.org/10.1111/nmo.13463

Journal Article Type Article
Acceptance Date Aug 8, 2018
Online Publication Date Sep 14, 2018
Publication Date Dec 10, 2018
Deposit Date Dec 13, 2018
Publicly Available Date Sep 15, 2019
Journal Neurogastroenterology & Motility
Print ISSN 1350-1925
Electronic ISSN 1365-2982
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 30
Issue 12
Article Number e13463
DOI https://doi.org/10.1111/nmo.13463
Keywords Gastroenterology; Physiology; Endocrine and Autonomic Systems
Public URL https://nottingham-repository.worktribe.com/output/1411808
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1111/nmo.13463
Contract Date Dec 13, 2018