A survey of the clinical use of SeHCAT in the UK.

BACKGROUND: The radiopharmaceutical 23-(Se)selena-25-homotaurocholic acid (SeHCAT), introduced 30 years ago, serves as a convenient and reliable diagnostic test for bile acid malabsorption. Recent advances in understanding the pathophysiology of bile acid diarrhoea have led to increased use of SeHCAT; however, some questions on its applicability remain unanswered. To obtain a better understanding of the application of this diagnostic test, a national survey was carried out within the UK.
METHODS: A web-based semistructured questionnaire was used. Invitations to participate were sent to the lead contacts of the 227 Nuclear Medicine Departments in the UK known to the British Nuclear Medicine Society. Information was sought on workload, trends in referrals, acquisition protocols, patient preparation, results, normal ranges and interpretation. For those not using SeHCAT, questions on reasons for not using the test and intentions to commence its use in the future were asked.
RESULTS: Responses from 129 UK centres were included in analysis. Seventy-three of these (57%) used SeHCAT in diagnosis, and most of them reported an increase in referrals over the last 3 years. Several departments have started using SeHCAT recently in response to demand from clinicians. There was considerable variability in the practical implementation of the technique and the 'normal' range used for reporting.
CONCLUSION: The findings from the survey have provided a better understanding of how diagnosis using SeHCAT is carried out in the UK. An important finding was the wide variation in the normal reference values used for diagnostic reporting. Establishing greater consistency in the interpretation and reporting of the results of this test would be of considerable clinical value.