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EnsurePlus as an Alternative to the Standardized Egg Gastric-Emptying Meal

Solnes, Lilja B., MD; Sheikhbahaei, Sara, MD; Ziessman, Harvey A., MD

doi: 10.1097/RLU.0000000000002553
Original Articles

Objectives The purpose of this study was to establish normal gastric-emptying values for EnsurePlus in healthy subjects and to determine whether it is an acceptable alternative to the recommended standardized 99mTc–sulfur colloid egg meal.

Methods Twenty-one healthy subjects underwent gastric-emptying scintigraphy with 111In-DTPA EnsurePlus. Normal gastric emptying values were established for 1, 2, 3, and 4 hours after meal ingestion. The gastric-emptying results were compared with another group of normal subjects (n = 18) who ingested the standardized egg meal.

Results The mean (95% upper reference limit) percentages for gastric retention for EnsurePlus were as follows: 69.9% (87.1%) at 1 hour, 35.1% (64.3%) at 2 hours, 13.5% (23.2%) at 3, and 8.9% (13.5%) at 4 hours. There were time-related differences in the gastric emptying of the EnsurePlus compared with the egg meal. In the first and second hours, there were no difference between EnsurePlus and the egg meal in terms of percentage retention (P = 0.92 at 1 hour, P = 0.05 at 2 hours). However, at 3 and 4 hours after meal ingestion, the mean percentage gastric retention of the EnsurePlus was significantly higher than the egg meal (P < 0.001).

Conclusion EnsurePlus is a good and acceptable alternative to the standardized egg meal.

From The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD.

Received for publication January 14, 2019; revision accepted February 7, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Harvey A. Ziessman, MD, 601 N Caroline St, JHOC 3231, Baltimore, MD 21287. E-mail:

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.