Korean J Nucl Med.  2005 Jun;39(3):151-162.

Evaluation of Hepatic Hemangioma by Tc-99m Red Blood Cell Hepatic Blood Pool Scan

• Sohn MH

Abstract

Hemangioma is the most common benign tumor of the liver, with a prevalence estimated as high as 7%. Tc-99m red blood cell (RBC) hepatic blood pool scan with single photon emission computed tomography (SPECT) imaging is extremely useful for the confirmation or exclusion of hepatic hemangiomas. The classic finding of absent or decreased perfusion and increased blood pooling ("perfusion/blood pool mismatch") is the key diagnostic element in the diagnosis of hemangiomas. The combination of early arterial flow and delayed blood pooling ("perfusion/blood pool match") is shown uncommonly. In giant hemangioma, filling with radioactivity appears first in the periphery, with progressive central fill-in on sequential RBC blood pool scan. However, the reverse filling pattern, which begins first in the center with progressive peripheral filling, is also rarely seen. Studies with false-positive blood pooling have been reported infrequently in nonhemangiomas, including hemangiosarcoma, hepatocellular carcinoma, hepatic adenoma, and metastatic carcinomas (adenocarcinoma of the colon, small cell carcinoma of the lung, neruroendocrine carcinoma). False-negative results have been also reported rarely except for small hemagniomas that are below the limits of spatial resolution of gamma camera.

Keyword

Hepatic hemangioma; Tc-99m RBC; blood pool scan; SPECT; false-positive; false-negative

MeSH Terms

Adenoma
Carcinoma, Hepatocellular
Carcinoma, Small Cell
Colon
Diagnosis
Erythrocytes*
Gamma Cameras
Hemangioma*
Hemangiosarcoma
Liver
Lung
Perfusion
Prevalence
Radioactivity
Tomography, Emission-Computed, Single-Photon