{
  "abstract": "Background Although gastric emptying scintigraphy (GES) is the reference standard for diagnosing gastroparesis, its time-consuming nature, high cost, and radiation exposure limit clinical application. We aimed to derive and validate a practical rapid gastric ultrasonography (GUS) threshold for gastroparesis.Methods We conducted a prospective diagnostic accuracy study comparing GUS with GES for gastroparesis ( IDDF2026-ABS-0214 Figure 1. Ultrasonographic phenotype of gastric antrum cross-section at different time points). Participants undergoing both examinations were prospectively enrolled and temporally divided into training and validation cohorts (IDDF2026-ABS-0214 Table 1). Using GES as the reference standard, the optimal GUS cut-off was derived by ROC analysis in the training cohort and tested in an independent validation cohort. Diagnostic agreement was assessed with McNemar’s test and Cohen’s κ, and correlations with symptom scores using Steiger’s test.Results Among 98 participants, 32 (32.7%) were diagnosed with gastroparesis. The 15-minute GUS-derived gastric emptying rate (GUS15min) showed the strongest correlation with GES-derived emptying rates (2-hour r = 0.51; 4-hour r = 0.50; both p < 0.0001). In the training cohort, the optimal GUS15min cut-off was 0.194 (AUC 0.91; 95% CI 0.83-0.991; IDDF2026-ABS-0214 Figure 2. The discriminative ability of Gus Ger in training cohort, IDDF2026-ABS-0214 Figure 4. Diagnostic performance of GUS at different time points in training cohort). In the validation cohort, a rounded threshold of 0.200 yielded an AUC of 0.85 (95% CI 0.70-1.00), sensitivity of 91.7%, and specificity of 85.7%; agreement with GES240min was substantial (Cohen’s κ = 0.773) and McNemar’s test was non-significant (IDDF2026-ABS-0214 Table 2). GUS15min showed a stronger correlation with symptom ­severity than GES240min (Spearman r = −0.61 vs. −0.35; Steiger’s test, p = 0.026; IDDF2026-ABS-0214 Figure 3. Correlation analysis between Gus Ges and clinical parameters).Conclusions GUS, using a GUS 15min < 20.0% as the optimal cut-off, serves as a rapid and practical diagnostic tool for gastroparesis, offering enhanced correlation with clinical symptoms and facilitating early identification of gastroparesis.Abstract IDDF2026-ABS-0214 Table 1Baseline characteristics of the training and validation cohortsVariablesTotal (n = 98)Training cohort (n = 58)Validation cohort (n = 40)pAge, M (Q1, Q3)42.0 (34.0, 53.0)42.0 (34.0, 51.8)42.0 (35.8, 53.0)0.696Sex, n (%)0.373 Female56 (57.14)31 (53.5)25 (62.5) Male42 (42.86)27 (46.6)15 (37.5)BMI, M (Q1, Q3)20.3 (18.4, 23.3)20.4 (18.5, 23.2)19.8 (17.7, 23.5)0.534GCSI, M (Q1, Q3)2.19(1.17, 2.77)2.32 (1.09, 2.78)1.60 (1.17, 2.36)0.052Gastroparesis, n (%)0.642 No66 (67.4)38 (65.5)28 (70.0) Yes32 (32.6)20 (34.5)12 (30.0)Diabetes, n (%)0.399 No44 (44.9)24 (41.4)20 (50.0) Yes54 (55.1)34 (58.6)20 (50.0)Surgery, n (%)0.213DD No80 (81.6)45 (77.6)35 (87.5) Yes18 (18.4)13 (22.4)5 (12.5)Gastroptosis, n (%)0.284 No83 (84.7)51 (87.9)32 (80.0) Yes15 (15.3)7 (12.1)8 (20.0)GUS15min, M (Q1, Q3)0.23 (0.15, 0.37)0.22 (0.16, 0.35)0.30 (0.14, 0.41)0.280GUS30min, Mean ± SD0.45 ± 0.210.42 ± 0.190.48 ± 0.240.169GUS45min, Mean ± SD0.61 ± 0.210.58 ± 0.210.64 ± 0.210.215GUS60min, M (Q1, Q3)0.73 (0.55, 0.89)0.72 (0.53, 0.86)0.76 (0.59, 0.91)0.334AMI15min, M (Q1, Q3)2.93 (1.27, 3.88)2.93 (1.43, 3.80)2.92 (1.09, 3.93)0.960AMI30min, M (Q1, Q3)2.58 (1.16, 3.56)2.35 (0.96, 3.26)2.77 (1.76, 3.88)0.130AMI45min, M (Q1, Q3)2.04 (1.04, 3.18)1.98 (0.79, 2.97)2.15 (1.39, 3.42)0.216AMI60min, M (Q1, Q3)1.65 (0.86, 2.60)1.55 (0.68, 2.50)1.93 (0.93, 2.62)0.306GESHET, M (Q1, Q3)112.8 (85.0, 170.2)117.4 (97.2, 198.2)105.3 (75.6, 149.1)0.179Abstract IDDF2026-ABS-0214 Figure 1Abstract IDDF2026-ABS-0214 Table 2Diagnostic performance of GUS-GER15min in validation cohortGERGESPKappaAUC (95% CI)Sensitivity (95% CI)Specificity (95% CI)PPVNPVGastroparesisNon-gastroparesisGUS15min0.6250.7730.85 (0.70-1.00)0.92 (0.62-0.99)0.89 (0.72-0.988)0.7860.962< 19.4%113≥ 19.4%125GUS15min0.6250.7730.85 (0.70-1.00)0.92 (0.62-0.99)0.89 (0.72-0.988)0.7860.962< 20.0%113≥ 20.0%125Abstract IDDF2026-ABS-0214 Figure 2Abstract IDDF2026-ABS-0214 Figure 3Abstract IDDF2026-ABS-0214 Figure 4",
  "authors": [
    {
      "affiliations": [
        "Department of Microbiota Medicine & Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Zheyu Wang"
    },
    {
      "affiliations": [
        "Department of Microbiota Medicine & Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Mengxi Ma"
    },
    {
      "affiliations": [
        "Department of Nuclear Medicine, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Xiaofei Xu"
    },
    {
      "affiliations": [
        "Department of Health Statistics, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Xiaoshuang Xu"
    },
    {
      "affiliations": [
        "Department of Ultrasound Medicine, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Kangtai Lv"
    },
    {
      "affiliations": [
        "Department of Microbiota Medicine & Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Xia Wu"
    },
    {
      "affiliations": [
        "Department of Ultrasound Medicine, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Juan Wang"
    },
    {
      "affiliations": [
        "Department of Microbiota Medicine & Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, China"
      ],
      "name": "Faming Zhang"
    }
  ],
  "title": "IDDF2026-ABS-0214 Development and validation of a rapid 15-minute gastric ultrasound protocol for diagnosing gastroparesis: a prospective cohort study",
  "uid": "00ffd83f-22da-50dc-9176-c399e9f439bc"
}