E4988. Modern Utility of Fluoroscopic Barium Burger Study for the Assessment of Gastric Emptying
  1. Kiera Mason; Baylor University Medical Center
  2. Emily Gonzalez; Baylor University Medical Center
  3. Michelle Thieu; Texas A&M College of Medicine
  4. Cory Pfeifer; Phoenix Children's
The barium burger study is a fluoroscopic study that uses barium mixed with a standardized hamburger volume and fluoroscopic imaging at standardized timed intervals to evaluate the patient’s gastric motility. The barium burger study is applicable in patients with concerns for delayed or accelerated gastric emptying. Barium burger studies are invaluable in smaller hospitals deprived of easily accessible nuclear medicine services. The barium burger protocol is easily replicable by radiologic technologists and requires low radiation doses. A barium burger study has an effective dose of 0.35 mSv, in comparison to 0.4 mSv of a nuclear medicine gastric emptying examination. Despite this, the barium burger study is not frequently enlisted as a first-line test; however, it remains feasible as a first-line evaluation of gastric function when a nuclear medicine gastric emptying study may be difficult to obtain.

Educational Goals / Teaching Points
The protocol of the barium-coated burger fluoroscopy examination will be detailed. The continued utility of barium burger studies as an alternative to nuclear medicine gastric emptying studies will be highlighted. The best clinical setting and contexts are included. Interpretation of the study will be discussed.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The protocol for the barium burger study consists of three steps. First, the patient consumes a standardized volume of burger meal mixed with barium pudding. AP and lateral abdominal radiographs are taken immediately after ingestion, at 30 minutes, and 90 minutes after ingestion. The residual gastric volume is measured in three dimensions, and the volume is estimated at these intervals using the formula: 1 – (F - E/F) × 100. In a normal study, more than 70% of the contents should remain in the stomach. Less than 10% retained volume at 1 hour indicates gastric acceleration. Retention greater than 6 hours is considered prolonged.

Measurement of retained barium-coated hamburger used as an important substitute for nuclear medicine gastric emptying studies. Understanding and performing a barium burger study can be essential in diagnosing gastric motility disorders.