75 Se-selenomethionine scanning in the diagnosis of tumours of the pancreas and adjacent viscera: the use of the test and its impact on survival.

The results of pancreatic scanning with (75)Se-selenomethionine in 393 carefully documented patients over a two-year period are presented. On follow up 50 patients had operatively proven malignant tumours in the gland and a further 22 had similar tumours in adjacent organs, clinically mimicking carcinoma of the pancreas and in many cases causing scan abnormalities. Five patients had pancreatic adenomata. Remote tumours rarely affected the scan. Examination of the role of scanning in patients with neoplastic disease revealed that the test was effective in screening and in detection; false negative diagnoses were rare. By contrast, survival following diagnosis was extremely poor with only 8% of pancreatic tumours resectable and 50% metastasized at the time of surgery. Causes of pancreatic dysfunction, other than pancreatitis or carcinoma, which were associated with abnormalities on the scan are described and general aspects of reporting on the scan are discussed. The patterns seen in abnormal scans, while non-specific with regard to aetiology, were anatomically meaningful and useful adjuncts to the diagnosis of pancreatic disease. A normal scan excluded pancreatic cancer with a probability greater than 95%.