Esophageal motility classification can be established at the time of endoscopy: a study evaluating real-time functional luminal imaging probe panometry

Dustin A. Carlson*, C. Prakash Gyawali, Peter J. Kahrilas, Joseph R. Triggs, Sophia Falmagne, Jacqueline Prescott, Emily Dorian, Wenjun Kou, Zhiyue Lin, John E. Pandolfino

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background and Aims: A novel device that provides real-time depiction of functional luminal image probe (FLIP) panometry (ie, esophagogastric junction [EGJ] distensibility and distension-induced contractility) was evaluated. We aimed to compare real-time FLIP panometry interpretation at the time of sedated endoscopy with high-resolution manometry (HRM) in evaluating esophageal motility. Methods: Forty consecutive patients (aged 24-81 years; 60% women) referred for endoscopy with a plan for future HRM from 2 centers were prospectively evaluated with real-time FLIP panometry during sedated upper endoscopy. The EGJ distensibility index and contractility profile were applied to derive a FLIP panometry classification at the time of endoscopy and again (post-hoc) using a customized program. HRM was classified according to the Chicago classification. Results: Real-time FLIP panometry motility classification was abnormal in 29 patients (73%), 19 (66%) of whom had a subsequent major motility disorder on HRM. All 9 patients with an HRM diagnosis of achalasia had abnormal real-time FLIP panometry classifications. Eleven patients (33%) had normal motility on real-time FLIP panometry and 8 (73%) had a subsequent HRM without a major motility disorder. There was excellent agreement (κ = .939) between real-time and post-hoc FLIP panometry interpretation of abnormal motility. Conclusions: This prospective, multicentered study demonstrated that real-time FLIP panometry could detect abnormal esophageal motility, including achalasia, at the endoscopic encounter. Additionally, normal motility on FLIP panometry was predictive of a benign HRM. Thus, real-time FLIP panometry incorporated with endoscopy appears to provide a suitable and well-tolerated point-of-care esophageal motility assessment.

Original languageEnglish (US)
Pages (from-to)915-923.e1
JournalGastrointestinal endoscopy
Volume90
Issue number6
DOIs
StatePublished - Dec 2019

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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