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Effects of the frame acquisition rate on the sensitivity of gastro-oesophageal reflux scintigraphy.

OBJECTIVE
To compare the sensitivity of gastro-oesophageal reflux (GOR) scintigraphy at 5-s and 60-s frame acquisition rates.


METHODS
GOR scintigraphy of 50 subjects (1 month-20 years old, mean 42 months) were analysed concurrently using 5-s and 60-s acquisition frames. Reflux episodes were graded as low if activity was detected in the distal half of the oesophagus and high if activity was detected in its upper half or in the oral cavity. For comparison purposes, detected GOR in any number of 5-s frames corresponding to one 60-s frame was counted as one episode.


RESULTS
A total of 679 episodes of GOR to the upper oesophagus were counted using a 5-s acquisition technique. Only 183 of such episodes were detected on 60-s acquisition images. To the lower oesophagus, a total of 1749 GOR episodes were detected using a 5-s acquisition technique and only 1045 episodes using 60-s acquisition frames (these also included the high-level GOR on 5-s frames counted as low level on 60-s acquisition frames). 10 patients had high-level GOR episodes that were detected only using a 5-s acquisition technique, leading to a different diagnosis in these patients. No correlation between the number of reflux episodes and the gastric emptying rates was noted.


CONCLUSION
The 5-s frame acquisition technique is more sensitive than the 60-s frame acquisition technique for detecting both high- and low-level GOR.


ADVANCES IN KNOWLEDGE
Brief GOR episodes with a relatively low number of radioactive counts are frequently indistinguishable from intense background activity on 60-s acquisition frames.