World Journal of Nuclear Medicine

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 19  |  Issue : 4  |  Page : 353--358

Improving Hepatobiliary Imaging as a Physiologic Test with Superior Clinical Outcomes


Isis W Gayed1, Lydia Dawood1, Zhang Xu2, Grace Rizk1, Andrew Dupont3, Monica Atta1, Emily K Robinson4 
1 Department of Diagnostic and Interventional Imaging, Nuclear Medicine Section, Houston, Texas, USA
2 Department of Internal Medicine, UTHealth McGovern Medical School, University of Texas, Houston, Texas, USA
3 Department of Gastroenterology, UTHealth McGovern Medical School, University of Texas, Houston, Texas, USA
4 Department of Surgery, UTHealth McGovern Medical School, University of Texas, Houston, Texas, USA

Correspondence Address:
Prof. Isis W Gayed
Department of Diagnostic and Interventional Imaging Nuclear Medicine Section, McGovern Medical School, University of Texas, Houston, Texas
USA

This study aims at prospectively evaluating the difference in the effect of cholecystokinin (CCK) and half-and-half milk (HHM) administered in the same patient on gallbladder contractility and correlation with clinical outcomes. Upon gallbladder visualization during standard hepatobiliary imaging, 0.02 μg/kg of CCK was injected over 3 min, and additional 30 min of dynamic imaging was obtained. Patients with gallbladder ejection fraction (GBEF) <35% after CCK were administered 8 oz of HHM followed by 30 min of imaging. The GBEF was recalculated. The number of patients whom GBEF changed from below 35% (abnormal) after CCK to above 35% (normal) after HHM was recorded. Follow-up of the clinical outcome at 6 months was performed. Fifty patients with abnormal GBEF were prospectively included. The average GBEF after CCK was 14.7% ± 8.5% and after HHM was 30.7% ± 20.8%. The average increase in GBEF with HHM was 16.0% ± 22.2%. The GBEF changed from abnormal to normal in 17 patients (34%). The remaining 33 patients remained abnormal. Clinical outcomes at 6 months were available in 47 patients. Cholecystectomy was performed in 60% of patients with abnormal GBEF with CCK and HHM with resolution or improvement of pain. Two of 16 patients (12%) with abnormal GBEF after CCK but normal after HHM had cholecystectomies with pain improvement, while 8 out of these patients (50%) were diagnosed and treated with other disorders and improved. Hepatobiliary imaging with HHM stimulation is a superior physiologic test which can lower the number of unnecessary cholecystectomies and misdiagnoses as functional cholecystitis.


How to cite this article:
Gayed IW, Dawood L, Xu Z, Rizk G, Dupont A, Atta M, Robinson EK. Improving Hepatobiliary Imaging as a Physiologic Test with Superior Clinical Outcomes.World J Nucl Med 2020;19:353-358


How to cite this URL:
Gayed IW, Dawood L, Xu Z, Rizk G, Dupont A, Atta M, Robinson EK. Improving Hepatobiliary Imaging as a Physiologic Test with Superior Clinical Outcomes. World J Nucl Med [serial online] 2020 [cited 2021 Jan 27 ];19:353-358
Available from: http://www.wjnm.org/article.asp?issn=1450-1147;year=2020;volume=19;issue=4;spage=353;epage=358;aulast=Gayed;type=0