HYBRID IMAGING FOR FUNCTIONAL DYSPEPSIA
Gastric Accommodation & Mucosal Uptake Study using Quantitative Hybrid SPECT/CT in Healthy Volunteers and Functional Dyspepsia Patients
Functional dyspepsia (FD) is a collection of clinical syndromes characterized by recurrent epigastric pain, postprandial fullness, early satiety, and/or bloating without any structurally abnormal upper gastrointestinal endoscopy. The pathophysiology of FD is multifactorial, and the suggested pathways include dysfunctional gastric accommodation (GA) and low-grade inflammation. At present, gastric barostat studies remain as the gold-standard test to investigate GA which involves a large balloon to be swallowed by the patient. The main drawback, however, is the invasive and stressful nature of its use. Plus, the presence of a balloon interferes with natural physiology. As a consequence, it is an unattractive instrument for general diagnostic purposes and also for the estimation of treatment effects in clinical trials that involve repeated measurements.
Previously, single-photon emission computed tomography (SPECT) of the gastric mucosa has been developed as a non-invasive actionable biomarker to quantify GA. It allows precise quantification of bolus passage to the fundus, which serves as a reservoir for ingested food without greatly increasing the intragastric pressure. Regardless, this technique has remained the same since its first reported application 20 years ago. In the advent of more advanced imaging modality, the team proposes the use of quantitative hybrid SPECT/CT to measure both GA and low-grade inflammation simultaneously for the assessment of stomach function.
It is hoped that with positive results, this modality can be used for frequent examinations and to track the progress of patients completing treatment regimens. With protocol optimization for widespread clinical translation, the technique developed in this project may be applied to modern, hybrid SPECT/CT scanners equipped with quantitative software.
Project aims
Develop analytic methods and optimize imaging protocol for the implementation of quantitative hybrid SPECT/CT in both phantom and human study.
Characterize and quantify dysfunctional GA using SPECT/CT volumetry, and low-grade inflammation using standardized mucosal uptake value.
Study the relationship between volumetry, standardized mucosal uptake value, and other clinical measurements.
Conclusions
In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews.