Scintillography in the Diagnosis of Pancreatic Disease

Brown, Pamela; Sircus, W.; Smith, A. N.; Donaldson, A. A.; Dymock, I. W.; Falconer, C. W. A.; Small, W.

doi:10.1016/s0140-6736(68)92560-9

Cited by 25 publications

(8 citation statements)

References 7 publications

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“…Two studies (Lahdevirta, 1967;Brown, Sircus, Smith, Donaldson, Dymock, Falconer, and Small, 1968) have indicated some correlation between the results of scanning and those of routine exocrine function tests. However, the first study was restricted 'Request for reprints should be sent to D.M.McC., Department of Medicine, Royal Free Hospital, Gray's Inn Road,London,WC1. to 19 diabetic patients who may be atypical with regard to pancreatic function.…”

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confidence: 99%

Measurement of duodenal tryptic activity and 75Se-selenomethionine pancreatic scanning compared as tests of pancreatic function

McCarthy¹,

Brown²

1969

Gut

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As 75Se-selenomethionine is incorporated into newly synthesized protein components of the pancreas (Hansson and Blau, 1963) and appears rapidly in secreted enzymes (Van Goidsenhoven, Denk, and Knight, 1965), it seemed logical to compare with the scan the result of a test of enzyme synthesis, and therefore acinar cell function, rath-r than a test of the volume and bicarbonate secretory capacity of the gland in which acinar function may be less important. The Lundh test (Lundh, 1962;Bramwell Cook, Lennard-Jones, Sherif, and Wiggins, 1967) seemed to satisfy this requirement. It is simple to perfotm and furthermore employs only the physiological stimulus of a standard meal before the test.

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confidence: 99%

Measurement of duodenal tryptic activity and 75Se-selenomethionine pancreatic scanning compared as tests of pancreatic function

McCarthy¹,

Brown²

1969

Gut

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“…Photoscans of the pancreas give direct information about pancreatic morphology and function (Brown et al, 1968) but edge differentiation is poor and the technique is most likely to fail when the periphery of the gland is abnormal. Radiographic techniques yield only indirect information on pancreatic morphology and are of least use when the periphery of the gland is normally shaped and situated, irrespective of pathology in other parts.…”

Section: Discussionmentioning

confidence: 99%

“…riguez-Antu(nez, Filson, Sullivan, and Brown, 1966;Centi Colella and Pigorini, 1967;Brown, Sircus, Smith, Donaldson, Dymock, Falconer, and Small, 1968;Melmed, Agnew, and Bouchier, 1968) and hypotonic duodenography (Raia and Kreel, 1966;Bilbao, Frische, Dotter, and Rosch, 1967;Kreel, 1969;Martel, 1968) have proved to be simple, safe procedures particularly when 'tubeless' hypotonic duodenography is employed. Our experience is similar to that of Eaton et al (1968) and suggests that these are generally the most useful techniques employed in the diagnosis of pancreatitis and pancreatic carcinoma, though distinction between the two conditions is often difficult.…”

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Value of hypotonic duodenography as an adjunct to pancreatic scanning

McCarthy¹,

Kreel²,

Agnew³

et al. 1969

Gut

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LondonSUMMARY A technique has been developed which allows the position of the upper gastrointestinal tract, as determined radiographically, to be superimposed on the pancreatic photoscan, performed after an injection of 75Se-selenomethionine. Results of the technique applied to 27 'abnormal' and 23 'normal' subjects are described. The importance of the additional information gained by the combined technique is discussed in terms of normal variation and increased diagnostic yield, and the situations in which it was found most useful are described. The addition of correlated duodenography rendered scan reporting more objective in 50 % of cases.Comparisons of the usefulness of radiological and other techniques in solving specific diagnostic problems in pancreatic disease have been undertaken by a number of workers (Sullivan, Meaney, Rodriguez-Antunez, and : Kreel, 1967Eaton, Fleischli, Pollard, Nebesar, and Portsaid, 1968). The reports suggest that all the techniques have well defined 'blind spots'. Pancreatic scanning after injection of 75Se-selenomethionine (Rodriguez-Antu(nez, Filson, Sullivan, and Brown, 1966;Centi Colella and Pigorini, 1967;Brown, Sircus, Smith, Donaldson, Dymock, Falconer, and Small, 1968;Melmed, Agnew, and Bouchier, 1968) and hypotonic duodenography (Raia and Kreel, 1966;Bilbao, Frische, Dotter, and Rosch, 1967;Kreel, 1969;Martel, 1968) have proved to be simple, safe procedures particularly when 'tubeless' hypotonic duodenography is employed. Our experience is similar to that of Eaton et al (1968) and suggests that these are generally the most useful techniques employed in the diagnosis of pancreatitis and pancreatic carcinoma, though distinction between the two conditions is often difficult.A technique, described below, has been developed which allows the position of the duodenal loop, as determined by duodenography, to be superimposed on the photoscan. Using this technique a study was undertaken aimed primarily at answering the question, 'Does the addition of correlated hypotonic duodenography as a routine procedure in patients subjected to pancreatic scanning yield additional information helpful to the interpretation of the scan?'The study also allowed close examination of the scan in difficult interpretive situations. These arise when glandular uptake of the isotope is poor and not greatly in excess of background activity; when the isotope appears in abnormal sites or concentrations; or when the liver or bowel overlaps the pancreas. Under such conditions it may be difficult if not impossible to delineate precise boundaries of the gland. For such reasons one-tenth of scans are unreadable and as many more are interpreted with little confidence. The technique was therefore employed in the hope of reducing this uncertainty and it permitted close study of isotope distribution in the context of known anatomical relations of the pancreas. As no similar studies had been previously reported, interpretation of the results of the study was carried out at a communal reporting session for the first 3...

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“…Pancreatic scanning using 85Se is claimed to give similar results to the Lundh test (McCarthy and Brown, 1969), to the secretin test in diabetic patients (Lahdevirta, 1967), and to the secretin-CCK-PZ test (Brown et al, 1968), but Levrat and colleagues (1970) thought it less reliable than the secretin test in patients with a normal pancreas and in cases of chronic pancreatitis. Youngs and colleagues (1973) compared scanning with the Lundh test and found that the two tests were equally reliable in chronic pancreatitis but false abnormal scans occurred in patients with a normal pancreas.…”

Section: Comparison Of Pancreatic Function Tests and Selection Of Tesmentioning

confidence: 99%

Tests of Exocrine Pancreatic Function

Gowenlock

1977

Ann Clin Biochem

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Scintillography in the Diagnosis of Pancreatic Disease

Cited by 25 publications

References 7 publications

Measurement of duodenal tryptic activity and 75Se-selenomethionine pancreatic scanning compared as tests of pancreatic function

Measurement of duodenal tryptic activity and 75Se-selenomethionine pancreatic scanning compared as tests of pancreatic function

Value of hypotonic duodenography as an adjunct to pancreatic scanning

Tests of Exocrine Pancreatic Function

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