Gastric Emptying Study Report

Patient: [full name], MRN: [medical record number], DOB: [date of birth], Sex: [sex]

Exam Date: [date]

Exam: Gastric Emptying Study – [Solid / Liquid / Solid + Liquid]

Ordering Provider: [name]

Interpreting Physician: [name and credentials]

Indication

[Symptoms, clinical question, and relevant conditions/surgeries] (Include symptoms prompting study such as nausea, vomiting, early satiety, or bloating. Note relevant diagnoses and any prior gastric/foregut surgery as this affects reference ranges. If not provided, state "Indication: Not provided.")

Comparison

[Prior gastric emptying studies with dates and protocol differences; relevant anatomic imaging] (If none, state "None available.")

Technique

• Meal protocol: [standardized low-fat egg-white meal / alternative meal / nonstandard meal]; [percent consumed / Not recorded]; Ingestion time: [minutes / Not recorded]; Vomiting: [yes / no / Not recorded]
• Radiopharmaceutical: [agent] [administered activity in MBq or mCi], oral administration
• Imaging: [patient positioning]; [acquisition timepoints] (e.g., static images at 0, 1, 2, 3, 4 hours for solid; dynamic or intermittent for liquid)
• Quantification: [geometric mean / anterior-only]; decay correction [applied / not applied]
• Fasting status: [duration / Not recorded]
• Blood glucose at ingestion: [value / Not recorded / Not applicable] (Required for diabetic patients)
• Motility-affecting medications: [status of prokinetics, opioids, anticholinergics, GLP-1 agonists — held, continued, or not recorded]
• Other validity factors: [post-surgical anatomy, artifacts, protocol deviations / None]

(State "Not recorded" for critical variables if not documented. Do not assume standard conditions.)

Findings

Quantitative Results

Phase	Timepoint	% Retention	Reference Range
[Solid / Liquid]	[timepoint]	[% value / Not acquired / Limited]	[reference cutoff / Not applicable]

• Liquid phase T½: [half-emptying time in minutes / Not performed] (Include reference only if validated for the specific liquid protocol)
• Qualitative observations: [tracer layering, esophageal retention, antral hold-up, artifacts / None] (Include only if clinically relevant)

(Flag timepoints not acquired or limited by vomiting/overlap. State if standard reference ranges do not apply due to nonstandard meal or post-surgical anatomy.)

Impression

1. [Normal / Delayed / Rapid] gastric emptying, [Solid / Liquid / Both] phase — [key supporting retention value(s) with timepoint(s)].
2. [Study validity and limitations: protocol deviations, incomplete meal, vomiting, missing timepoints, post-surgical anatomy, medication effects, glucose considerations]. (State if standardized reference ranges do not apply.)
3. [Comparison with prior study: Improved / Stable / Worsened / Protocol differences preclude direct comparison]. (Include only if prior comparable study exists.)