None listed
Conditions
Brief summary
Background:: Optimising gastric conduit emptying post oesophagectomy is key to improving morbidity outcomes in a cohort of patients with increasingly long survivorship. It is thought that peristaltic function and resultant emptying of the gastric conduit improves over time. However, the relationship between peristalsis and conduit emptying has not been precisely delineated, nor has the presumed recovery. Aims:: In this study, we aim to investigate dynamic MRI as a technique to measure gastric conduit peristalsis in the mediastinum. We will use it to quantify the degree of peristalsis in the established gastric conduit and assess its correlation with emptying. We will also use quality of life and adverse symptom questionnaires to look for a relationship between peristalsis and gastrointestinal quality of life. Hypothesis: Dynamic MRI is an accurate way to measure gastric conduit peristalsis and conduit emptying. Peristaltic activity recovers post oesophagectomy and is more effective in narrower conduits. Brief Methods: Post oesophagectomy patients will be recruited greater than 2 years post oesophagectomy. Dynamic MRI will be performed, and questionnaires and demographic data collected Patients greater than 2 years post oesophagectomy and gastric conduit reconstruction will be prospectively recruited. Static and Dynamic MRIs will be performed in the supine position post consumption of a semisolid meal. Speed, length, and amplitude of peristaltic waves will be measured at 4 time points over a 20-minute period. Gastric Motility Index mm2/s (GMI) will be calculated (velocity x amplitude of peristaltic wave). Gastric conduit volumes will be calculated at the start and end of each MRI.
Interventions
Each participant (with a previous oesophagectomy) will present to the MRI department fasted for 8 hours. The MRI will take approximately 30 minutes.
Immediately prior to the MRI, the participant will consume a semi solid porridge meal, consisting of 34 grams of oats, sugar, honey, and milk powder.
An MRI will be performed by a specialised MRI radiographer, and the following sequences will be attained: T2 Volume acquisition, followed by T2 weighted true fast imaging with steady state free prece
Each participant (with a previous oesophagectomy) will present to the MRI department fasted for 8 hours. The MRI will take approximately 30 minutes. Immediately prior to the MRI, the participant will consume a semi solid porridge meal, consisting of 34 grams of oats, sugar, honey, and milk powder. An MRI will be performed by a specialised MRI radiographer, and the following sequences will be attained: T2 Volume acquisition, followed by T2 weighted true fast imaging with steady state free precession (TRUFI) free breathing sequence for 4 minutes. This block will be repeated 4 times. Then a final volume acquisition T2 Volume sequence will be completed. A specialised radiologist or surgeon investigator will be present for the scan to ensure all sequences are adequately completed. No IV contrast will be used. No further follow-up scans are required.
Sponsors
Alfred Health
Study design
Allocation
Non-randomised trial
Primary purpose
Diagnosis
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Interventional Group: > 2 years post oesophagectomy Control Group: Normal gastrointestinal Anatomy
Exclusion criteria
Interventional group: Known gastrointestinal dysmotility Medications that may affect gastric motility Recurrence of Cancer Prior gastrointestinal operations (other than oesopahgectomy) that may affect intestinal transit Control group: Known gastrointestinal dysmotility Medications that may affect gastric motility Prior gastrointestinal operations (other than oesopahgectomy) that may affect intestinal transit
Outcome results
None listed