99m Tc-sodium phytate is a valid alternative to the gold-standard 99m Tc-sulfur colloid in the measurement of gastric em
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RESEARCH ARTICLE
Open Access
99m
Tc-sodium phytate is a valid alternative to the gold-standard 99mTc-sulfur colloid in the measurement of gastric emptying among healthy multi-ethnic Asian population: results of a randomized crossover trial Norazlina Mat Nawi1,2†, Nashrulhaq Tagiling1†, Mohd Fazrin Mohd Rohani3, Wan Mohd Nazlee Wan Zainon2,4, Muhammad Saifuddin Zanial5, Mung Seong Wong2,6 and Yeong Yeh Lee2,6* Abstract Background: It is unclear if the 99mTc-sodium phytate (99mTc-SP) is as reliable as the gold-standard 99mTc-sulfur colloid (99mTc-SC) for gastric emptying scintigraphy (GES). This study is aimed to compare the emptying rates of both radiotracers in a prospective, randomized cross-over trial and to determine the normative data of a healthy multi-ethnic Asian population. Methods: Out of the 44 healthy individuals screened, 31 (14 females; mean age: 28.4 ± 7.0 years) were enrolled and underwent GES using the standardized egg-white meal. All participants were randomly assigned to either 99mTc-SP or 99mTc-SC on the first GES session before crossed over to the other formulation after 2 weeks. Results: Both kits achieved the radiochemical purities of > 95%. The median rate (95th upper normative limit) of gastric emptying, reported as total gastric meal retention between 99mTc-SP and 99mTc-SC, was found to be comparable at all measured time points: 0.5 h [85.0% (96.6%) vs. 82.0% (94.0%)], 1 h [70.0% (86.4%) vs. 65.0% (86.6%)], 2 h [31.0% (55.8%) vs. 25.0% (64.4%)], 3 h [7.0% (26.3%) vs. 5.0% (29.9%)], and 4 h [3.0% (10.3%) vs. 2.0% (9.9%)]; P > 0.05. In addition, both radiotracers correlated well (Kendall’s Tau (τ) coefficient = 0.498, P < 0.001) and presented with a good agreement at the 4th-hour time frame based on the Bland-Altman plot analysis. Conclusions: 99mTc-SP is a valid radiotracer alternative to 99mTc-SC for routine GES examination. The normative values for both radiotracers have also been determined for the healthy multi-ethnic Asian population. (Continued on next page)
* Correspondence: [email protected] † Norazlina Mat Nawi and Nashrulhaq Tagiling contributed equally and shared co-first authorship 2 Hospital USM, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia 6 Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and you
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