Dynamic MRI Grant to Study Gastric Sleeve Patients

The NewEngland Surgical Society Sholars Foundation has awarded a $10,000 grant to Richard A. Perugini, MD who will work with Radiologists Khashayar Rafatzand, MD and Laura Alonso, MD to complete the study. According to Dr. Perugini "This grant from NESS, amounts to $10,000 for the first year, with an interim report due and the possibility for a second year of funding. This should allow us to get off the ground with studying stomach morphology after sleeve gastrectomy, its impact on gastric emptying, incretins, and satiety. My guess is it will allow for 6 total patients, pre and post-op."

Assessment of the correlation between gastric morphology, gastric emptying, post prandial GLP-1 response, and hunger scores following longitudinal sleeve gastrectomy

Summary:  Longitudinal sleeve gastrectomy (LSG) is the most commonly performed bariatric operation. While the physiological mechanism by which LSG causes weight loss is unclear, early investigations indicate LSG causes augmention in the flow of nutrients through the stomach.  Our preliminary investigations lead us to believe LSG accelerates gastric emptying, which augments the postprandial secretion of midgut hormones, such as glucagon like peptide-1 (GLP-1), and satiety.  We hypothesize the extent to which LSG induces this physiologic effect can be predicted by the morphology of the stomach following resection.

We propose to directly test the impact of post surgical gastric morphology on gastric emptying, Glp-1 levels, and hunger/satiety, with the following specific aims:

1. Use dynamic MRI to measure stomach morphology
2. Use dynamic MRI to assess the kinetic rate of gastric emptying, the rate and amplitude of antral contraction, and presence of akinesis/hypokinesis of any segment of the gastric wall
3. Assess levels of Glp-1 in response to a mixed meal challenge
4. Assess hunger in response to a mixed meal challenge using a visual analog scale

We propose to study the above before and three months following LSG.  Our hope is that the knowledge gained will allow for a) refinement of the technique of LSG to improve weight loss and/or decrease complications, b) development of novel and less invasive interventions that mimic the physiologic effect of LSG, and c) exploration of LSG as a treatment for gastroparesis.

Read the proposal.