title: Imaging and retention measurements of selenium 75 homocholic acid conjugated with taurine, and the carbon 14 glycochol breath test to document ileal dysfunction due to late radiation damage.
abstract: In order to assess ileal dysfunction in patients with complaints after pelvic radiation therapy, retention measurements and scintigraphic imaging with selenium 75 homocholic acid conjugated with taurine (75Se-HCAT), combined with the carbon 14 glycochol breath test, were evaluated in 39 patients. In 22 patients without ileal resection the results of the 75Se-HCAT test and the breath test differentiated between a normal functioning ileum (both tests negative) and ileal dysfunction as a cause of complaints (one or both tests positive). Among the patients with ileal dysfunction, the combination of both tests permitted those with bacterial overgrowth (breath test positive, 75Se-HCAT negative) to be separated from patients with evidence of bile acid malabsorption (75Se-HCAT positive, breath test positive or negative). In 17 patients with small-bowel resection, the 75Se-HCAT test helped to estimate the severity of bile acid malabsorption with implications for therapy. In this group the breath test was false-negative in 7 cases with abnormal 75Se-HCAT. Additional systematically performed scintigraphic imaging improved the accuracy of the 75Se-HCAT test, revealing cases with prolonged colonic accumulation of the radiopharmaceutical, causing spurious retention values. In conclusion, assessment of ileal dysfunction by nuclear medicine techniques in post-irradiation conditions provides information about the aetiology and therefore the possibility of adjustment in the clinical management.
authors.affiliation: Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam.
authors.forename: R V
authors.initials: RV
authors.lastname: Olmos
authors.forename: F
authors.initials: F
authors.lastname: den Hartog Jager
authors.forename: C
authors.initials: C
authors.lastname: Hoefnagel
authors.forename: B
authors.initials: B
authors.lastname: Taal
mesh_terms: D000368:Aged; D001944:Breath Tests; D002250:Carbon Radioisotopes; D005260:Female; D006000:Glycocholic Acid; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000209:etiology; D007082:Ileum / Q000000981:diagnostic imaging; D008286:Malabsorption Syndromes / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011877:Radionuclide Imaging; D011878:Radiotherapy / Q000009:adverse effects*; D012644:Selenium Radioisotopes; D013656:Taurocholic Acid / Q000031:analogs & derivatives*; D013997:Time Factors
chemical_list: D002250:Carbon Radioisotopes; D012644:Selenium Radioisotopes; D013656:Taurocholic Acid; C033638:23-seleno-25-homotaurocholic acid; D006000:Glycocholic Acid