Evaluation of the ⁷⁵Se-<i>l</i>-Selenomethionine Test for Pancreatic Disease

Abstract

Radioselenium-secretin-pancreozymin tests have been performed in 22 normal subjects and in 23 patients with pancreatic exocrine insufficiency. Each subject received an intravenous injection of 50–100 μCi ⁷⁵Se-l-selenomethionine as a bolus which was followed by an intravenous infusion of secretin-CCK-PZ (1 CU/kg/h) for 2 h. Duodenal juice was collected from a double-lumen Lagerlöf tube and the ⁷⁵Se radioactivity measured. Gel filtrations on Sephadex G-50 were performed from samples of duodenal juice. Total duodenal radioactivity in pancreatic insufficient patients was significantly lower than in normal subjects 60–120 min after the start of the examination. When regarding the individual values of each subject an important overlap of normal and pancreatic insufficient persons could be observed. No difference in the gel filtration pattern was demonstrable between the two groups. From these results the use of ⁷⁵Se-l-selenomethionine for diagnostic purposes in pancreatic diseases cannot be recommended.

Pancreatic function testing

“…Based on this principle, the use of 75 Se‐methionine as a test of pancreatic function and as a method to visualize the pancreas by scintigraphy was introduced many years ago 81 ,. 82 75 Se‐methionine is given as an intravenous bolus injection, followed by pancreatic stimulation 82–84 . The protein‐bound radioactivity in the duodenal aspirates is used as an index of pancreatic exocrine function.…”

“…The protein‐bound radioactivity in the duodenal aspirates is used as an index of pancreatic exocrine function. Some studies reported a good separation of healthy controls and patients with chronic pancreatitis, 82 , 83 whereas more recent studies failed to show a sufficient sensitivity for this test 84–86 . The sensitivity and specificity of this test are both considerably less than those of the secretin–cholecystokinin stimulation test, despite being an equally invasive procedure requiring duodenal intubation and exposure to radioactive substances 4 …”

Pancreatic Synthetic Rates: A New Test of Pancreatic Function

“…(4) used an intravenous bolus dose of "Se-methionine and found good correlation between the specific activity of the selenium-75-labelled protein and the tryptic activity of the duodenal contents after a Lundh meal. In subsequent studies secretin and CCK were used to stimulate pancreatic secretion, and trichloroacetic acid was used to precipitate the protein-bound activity of the duodenal aspirate (5)(6)(7). In all these studies 75Se-methionine was given as an intravenous bolus * .…”