Hepatic scintiangiography using gamma camera system : diagnosis of hepatomas

Kim, C Y; Bahk, Y W; Yoon, S C

Abstract

The purpose of this investigation is to distinguish hepatomas from the liver abscess by hepaticscintiangiography using Anger camera system. Ninty-five patients were imaged by Gamma camera system in St. Mary'sHospital,, Catholic Medical College between May 1979 and Jan. 1980 and their medical records were reviewed indetail. Of a total of 95 patients were proved by histology. The patients were placed supine under Gamma cameradetector head to view the anterior projection of the liver and spleen. Following an intravenous bolus injection of10mCi Tc-99m-phytate in a volume of 3-4 ml, rapid sequential immaging 1 second duration was obtained for 16 and 30seconds, and recorded 16 to 30 images in one film. The 4-5 scintigiraphic images obtained from the time of thefirst appearance of radioactivity in the abdominal aorta untill its disappearance from the abdominal aorta wereclassified as the arterial phase of the study. In normal arterial phase, there is little or no radioactivity inthe hepatic bed., compared to the lungs, heart and right kidney. When a radioactivity (early arterial staining) isdepicted in the hepatic bed in the arterial phase of the scintiangiography, neoplastic condition is highlysuggested. Hepatoma(47 cases) and metastasis(4 cases) show that extremely high concentration ofradioactivity(early arterial staining) was noted in arterial phase in 44 cases and equivocal in 7 cases. A totalof early arterial staining finitely to neovascularization and feeding arteries of tumors. Liver abscess (4 cases)shows that appearance of radioactivity in the hepatic scintiangiogram as a whole was normal, except for reactiverim of hyperemia in arterial and early venous phases, but the area identified on the static liver imaging as acold area. The hepatic scintiangiography plus static liver imaging using gamma camera system is very newdiagnostic technique and proved effective in diagnosing hepatoma, metastasis and liver abscess. These findings areable to use as an aid in differential diagnosis of space-occupying lesions of the liver. We suggest that this testis therefore absolutely useful in differentiating abscess or cyst from neoplastic condition of the liver.