Recent advances in gastric emptying scintigraphy.

Gastric emptying scintigraphy was introduced more than 25 years ago by Griffith and still remains the gold standard to assess gastric emptying. Test meals, radiopharmaceutical and acquisition procedures have been refined and optimized over the years and the test procedure is now well standardized. However, in its most common use, gastric emptying scintigraphy provides little information on gastric physiology and pathophysiology. Over the last decade, modeling of the liquid- and solid-emptying curves has provided some insight into the complex gastric physiology. Compartmental analysis of the stomach has also provided information on the pathophysiological mechanisms of delayed gastric emptying. Over the past 5 years, the most dramatic development in gastric emptying scintigraphy has been the introduction of digital antral scintigraphy. Digital antral scintigraphy consists primarily of dynamic imaging of the stomach and a refined Fourier transform processing method. This new procedure allows for the visualization of antral contractions and, like manometry, permits quantitative characterization of the frequency and amplitude of these contractions. Overall, this new procedure provides a unique, noninvasive tool to characterize gastric motility, to define the pathophysiological mechanisms of gastric motor disorders, and to evaluate the effect of new gastrokinetic compounds.