Regional Center of Nuclear Medicine

In this issue of The Journal of Nuclear Medicine, Antoniou et al. describe a novel scintigraphic procedure designed to evaluate in a physiologic manner the transit of both the liquid and the solid components of a meal through virtually the entire gastrointestinal (GI) tract, starting with esophageal transit (1). Although the procedure is somewhat complex and laborious, it does offer the advantage of combining assessment of esophageal, gastric, small bowel, and colonic transit so as to obtain quantitative information on either the overall transit time and/or the separate components of transit from the esophagus to the more distal end of the gastrointestinal tract; the procedure also entails separate assessments of the liquid and of the solid components of a meal. This scenario has always attracted the attention of nuclear physicians, and indeed the first radionuclide technique combining evaluation of gastric emptying with evaluation of the small bowel and colon transit was published in 1975 (2). Various approaches have subsequently been described and reference ranges for normal values in healthy subjects have been defined (3,4); nevertheless, to date there is no scintigraphic protocol univocally recognized as the standard adopted worldwide, even for separate assessment of transit in the different portions of the GI tract, i.e., esophagus, stomach, small bowel, large bowel – although the recent publication o