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

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