The effects of N-butylscopolamine on bowel uptake: an 18F-FDG PET study

Nucl Med Commun. 2008 Jan;29(1):11-6. doi: 10.1097/MNM.0b013e3282f1d706.

Abstract

Purpose: To determine the effect of N-butylscopolamine (buscopan) on intestinal uptake of 18F-FDG.

Methods: Seventy-two oncology patients were prospectively studied and 36 patients received 20 mg of N-butylscopolamine intravenously. All patients were imaged with a Siemens PET scanner. After a 4-h fast, patients were injected with FDG and then scanned 1 h post-injection. Two experienced observers interpreted all studies independently. Scans were scored visually, grading 18F-FDG bowel uptake (0-3) and the influence of bowel uptake to a lack of confidence in scan reporting (0-3). For semi-quantitative comparison, the ratio of radiotracer uptake in the bowel to mean liver (B/L) was obtained.

Results: All results were in favour of N-butylscopolamine. For the qualitative data, a Mann-Whitney test was used. Results for contribution of bowel uptake to lack of confidence in reporting scores, showed P=0.0001 for observer 1, and P=0.002 for observer 2; for degree of uptake in bowel scores, observer 1 results gave a value of P=0.0001 and observer 2 P=0.001. For agreement of uptake scores, Kappa index showed 'moderate' agreement between observers for the control group and 'fair' agreement for the N-butylscopolamine group. For contribution of bowel uptake to lack of confidence scores, there was 'very good' agreement for the control group and 'fair' agreement for the N-butylscopolamine group. The semi-quantitative effect of N-butylscopolamine on bowel-to-liver ratio was determined using an unrelated t-test that produced significance at the level of P<0.001.

Conclusion: This study showed that administration of N-butylscopolamine can reduce artefacts in the bowel during 18F-FDG PET, and can potentially improve accuracy of 18F-FDG PET reporting.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Butylscopolammonium Bromide / administration & dosage
  • Butylscopolammonium Bromide / pharmacokinetics*
  • Contrast Media / administration & dosage
  • Contrast Media / pharmacokinetics
  • Female
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Humans
  • Image Enhancement / methods
  • Intestinal Absorption / drug effects*
  • Intestinal Mucosa / metabolism*
  • Intestines / drug effects*
  • Male
  • Middle Aged
  • Muscarinic Antagonists / administration & dosage
  • Muscarinic Antagonists / pharmacokinetics
  • Positron-Emission Tomography / methods
  • Radiopharmaceuticals

Substances

  • Contrast Media
  • Muscarinic Antagonists
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Butylscopolammonium Bromide