Ramli, Mohd Fahmi Shukur
(2017)
The Effectiveness Of Mebeverine
(Duspatalin) And Hyoscine-nbutylbromide (Buscopan) In
Reduction Of Physiological Bowel
Uptake In 18f-fdg Pet-ct.
Masters thesis, Universiti Sains Malaysia.
Abstract
Latar belakang: Pengagihan 18F-FDG dalam imbasan PET-CT adalah berdasarkan kepada
keperluan glukosa oleh sel-sel. Pengambilan 18F-FDG yang banyak oleh sel-sel yang
mempunyai metabolisma aktif seperti sel otot licin usus mampu menjejaskan tafsiran imej.
Kajian ini menilai keberkesanan Mebeverine (Duspatalin) dan Hyoscine-n-butylbromide
(Buscopan) dalam mengurangkan pengambilan 18F-FDG secara fisiologi oleh usus ketika
imbasan 18F-FDG PET-CT dijalankan.
Kaedah: Sebuah kajian prospektif rawak telah dijalankan kepada 195 pesakit yang menjalani
imbasan PET-CT di antara September 2016 hingga Februari 2017. Mereka dibahagikan kepada
3 kumpulan; 62 pesakit menerima 135mg ubat Mebeverine, 68 pesakit menerima 10mg ubat
Hyoscine-n-butylbromide manakala 65 pesakit adalah kumpulan kawalan. Semua pesakit
diimbas antara 45 minit ke 1 jam selepas suntikan 18F-FDG. Seorang pakar perubatan nuklear
telah menganalisa imej imbasan; SUVmean untuk usus dan nisbah SUVmean usus : hati telah
diperolehi untuk analisis statistik.
Keputusan: Nilai purata SUVmean dan nisbah SUVmean usus:hati di dalam ketiga-tiga kumpulan
adalah hampir sama. Tiada perbezaan yang signifikan antara purata SUVmean dan nisbah
SUVmean usus:hati di dalam ketiga-tiga kumpulan (p>0.050). Analisis kualitatif ke atas tahap
pengambilan 18F-FDG oleh usus dan kesukaran mentafsir imej dalam ketiga-tiga kumpulan
adalah tidak signifikan (p=0.302 dan p=0.957 masing-masing). Terdapat perkaitan yang positif
antara tahap pengambilan 18F-FDG dan kesukaran mentafsir imej (r=0.332, p<0.001).
Kesimpulan: Tiada kesan yang signifikan oleh Mebeverine dan Hyoscine-n-butylbromide
dalam pengurangan pengambilan 18F-FDG oleh usus secara fisiologi semasa imbasan PET-CT.
Semakin tinggi tahap pengambilan 18F-FDG dalam usus, semakin sukar untuk menafsir imej
imbasan.
.
.
Background: 18F-FDG distibution in PET-CT scan is based on glucose avidity of the cells.
Intense accumulation of 18F-FDG in in the cells with active metabolism like smooth muscles in
the bowel can affect the image interpretation. The aim of this study is to determine the effects of
Mebeverine (Duspatalin) and Hyoscine-n-butylbromide (Buscopan) in the reduction of
physiological bowel uptake in 18F-FDG PET-CT scan.
Methodology: A prospective randomised controlled trial was conducted for 195 patients whom
attended PET-CT scan between September 2016 and February 2017. They were divided into 3
groups; 62 patients received 135mg of oral Mebeverine, 68 patients received 10mg of oral
Hyoscine-n-butylbromide and 65 patients were in the control group. All patients were scanned
45 minutes to 1 hour after injection of 18F-FDG. An independent experienced interpreter
reviewed the images; SUVmean of bowel and bowel-to-liver ratio were obtained for statistical
analysis.
Results: There were almost equal values of mean SUVmean of bowel and bowel-to-liver ratio in
all groups. No significant different in mean SUVmean of bowel and bowel-to-liver ratio among
the three groups (p>0.050). There was no significant association of degree of bowel uptake and
difficulty of image interpretation in all the three groups (p=0.302 and p=0.957 respectively).
There was positive relationship between degree of bowel uptake and difficulty of image
interpretation (r=0.332, p<0.001).
Conclusion: There was no significant effect of Mebeverine and Hyoscine-n-butylbromide to
reduce physiological bowel uptake in 18F-FDG PET-CT. The higher the degree of bowel
uptake, the more difficult for the interpreter to interpret the images.
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