technetium-tc-99m-disofenin and Carcinoma--Hepatocellular

A 43-year-old man, previously submitted to right hepatectomy, right hepatic artery chemoembolization, and surgical resection of liver lesions, with well-differentiated and moderately differentiated hepatocellular carcinoma (HCC) confirmed by histopathology, underwent cholescintigraphy with Tc diisopropyliminodiacetic acid (Tc-DISIDA) due to recurrent cholangitis. The scintigraphic images and the coregistered CT images showed radiotracer uptake in an area of biliary ectasia near the hepatic surface (which may be associated with recurrent cholangitis), in a hepatic nodule, and in multiple pulmonary metastases.

Topics: Adult; Aged; Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Lung Neoplasms; Male; Multimodal Imaging; Technetium Tc 99m Disofenin; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

A hepatobiliary scan was performed on a patient presenting with symptoms of acute cholecystitis. In addition to cystic duct obstruction, there was a focal area of intense uptake in the left lobe of the liver. Additional imaging studies confirmed a solid mass in the left lobe of the liver, which proved to be a hepatocellular carcinoma on surgery.

Topics: Acute Disease; Adult; Carcinoma, Hepatocellular; Cholecystitis; Humans; Imino Acids; Liver Neoplasms; Male; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Disofenin

If conventional treatment modalities have failed in hepatoblastoma patients and no distant metastases can be demonstrated therapy with radionuclide agents can be considered. In 6 patients diagnostic technetium-99m (99mTc)-disofenin and two iodine-131 (131I)-rose bengal scans were made. 2 patients demonstrated specific uptake of disofenin. One of these had a positive scintigram with radiolabelled rose bengal. This patient was subsequently treated with 1.1 GBq 131I-rose bengal. No toxicity was observed. A clear decrease in the level of alpha-fetoprotein indicated a response and demonstrated that this radiopharmaceutical can be used for tumour targeted radiation therapy in selected patients with therapy resistant tumours.

Topics: Carcinoma, Hepatocellular; Female; Humans; Imino Acids; Infant; Iodine Radioisotopes; Liver; Liver Neoplasms; Male; Organotechnetium Compounds; Radionuclide Imaging; Rose Bengal; Technetium Tc 99m Disofenin

Topics: Adenoma; Carcinoma, Hepatocellular; Humans; Hyperplasia; Imino Acids; Liver Diseases; Liver Neoplasms; Organometallic Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin

In order to assess the usefulness of inferior vena cava flow studies and cholescintigraphy complementary to the routine static liver scintigraphy in the differential diagnosis of hepatocellular carcinoma (HCC), we studied 37 patients with a proven diagnosis of HCC and 11 patients with a liver abcess or cyst. The procedure followed was 1) a 99mTc-colloid flow study of the inferior vena cava (IVC) and iliac veins followed by static liver imaging and 2) cholescintigraphy using a dynamic acquisition mode to determine the perfusion as well as the concentration/excretion of the liver and pathological area. The hepatic perfusion index (HPI) was calculated by the "slope" method of Sarper et al.: Radiology 141:179-184 (1981) and the "area" method of Biersack et al.: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklear medizin. Erganzungsband 126:47-52 (1977). The results were compared with data previously collected in patients without liver disease (control) and other liver pathologies.

Topics: Carcinoma, Hepatocellular; Colloids; Diagnosis, Differential; Echinococcosis, Hepatic; Female; Humans; Iliac Vein; Imino Acids; Liver Abscess, Amebic; Liver Neoplasms; Male; Middle Aged; Organometallic Compounds; Radionuclide Imaging; Regional Blood Flow; Technetium; Technetium Compounds; Technetium Tc 99m Disofenin; Tin; Tin Compounds; Vena Cava, Inferior

Topics: Adult; Carcinoma, Hepatocellular; Female; Humans; Imino Acids; Liver Neoplasms; Lung Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Disofenin

Uptake of Tc-99m DISIDA in a bone metastasis from a hepatoma located at the humeral head is reported. Previous literature has only shown extrahepatic uptake of hepatobiliary agents in cases of lung metastases from hepatocellular carcinoma. The use of imaging with biliary tracers can increase the diagnostic specificity when bone metastases from hepatoma are suspected.

Topics: Bone Neoplasms; Carcinoma, Hepatocellular; Humans; Imino Acids; Liver Neoplasms; Male; Middle Aged; Organometallic Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin

A case of hepatocellular carcinoma demonstrating increased Tc-99m DISIDA concentration on both dynamic and static scans of the liver is presented.

Topics: Aged; Biliary Tract; Carcinoma, Hepatocellular; Humans; Imino Acids; Liver; Liver Neoplasms; Male; Organometallic Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin

The present investigation was aimed to assess the usefulness of biliary agents scintigraphy in the diagnosis of hepatocellular carcinoma (HCC) and to ascertain the relationship between the uptake of these agents and the degree of HCC differentiation. Forty-four patients with this hepatic cancer were included in the study. Liver scans were performed 20 min and 3 hr after the administration of 99mTc diisopropyliminodiacetic acid (DISIDA). DISIDA scintigraphy could not be assessed in six cases. In 16 (42%) out of the remaining 38 patients, the tumor exhibited equal or greater radioactivity uptake than the surrounding liver. In six out of these 16 patients, tumor uptake was apparent in the early and delayed hepatic scans, while in the other ten subjects radioactivity uptake by the HCC could only be detected in the 3-hr delayed scans. In the remaining 22 patients, HCC appeared as a cold area. Tumor location by this technique did not differ from that observed by 99mTc-sulfur colloid scan or ultrasound. DISIDA uptake was significantly related to tumor differentiation: 70% of those well differentiated tumors exhibited DISIDA uptake, whereas it was found in only 30% of those moderately differentiated and in none of those poorly differentiated (p less than 0.05). These results show that DISIDA scintigraphy can be useful in the diagnosis of HCC. Since its sensitivity is related to the degree of tumor differentiation, it may be indicated when aspiration cytology is unable to distinguish between well differentiated HCC and reactive changes due to hepatic cirrhosis.

Topics: Carcinoma, Hepatocellular; Female; Humans; Imino Acids; Liver Neoplasms; Male; Middle Aged; Organometallic Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin

Topics: Adult; Bone Neoplasms; Carcinoma, Hepatocellular; Humans; Imino Acids; Liver Neoplasms; Lung Neoplasms; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin

Topics: Carcinoma, Hepatocellular; Humans; Imino Acids; Liver Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin

Four consecutive cases of proven hepatocellular carcinoma (HCC) showed significant avidity of 99mTc -labeled iminodiacetic acids (Tc- IDAs ) in preoperative scintigraphy. In one patient, the pulmonary metastasis showed uptake of Tc-IDA. Such scintigraphic findings were obvious only in the delayed scans, performed 2 1/2-4 hr after injection. Since Tc- IDAs and bilirubin are functional analogs physiologically, the ability of HCC to concentrate Tc- IDAs may be related to the ability of HCC neoplastic cells to form bile intracellularly. This hypothesis is supported by the fact that intracellular bile granules were found in the tumor cells of all four patients. This suggests a potential for using Tc- IDAs for the specific and preoperative diagnostic of HCC.

Topics: Adult; Bile; Carcinoma, Hepatocellular; Humans; Imino Acids; Liver Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Lidofenin

Uptake of Tc-99m di-isopropyliminodiacetic acid (DISIDA) by hepatocellular carcinoma was assessed in 30 patients showing obvious liver defects on a Tc-99m tin colloid image. In none of these patients was there complete "filling in" of the defects, and even partial "filling in" occurred in only 11 (36.7%). There was no uptake of Tc-99m DISIDA by the primary tumor in the remaining 19 patients (63.3%). In 19 of the 30 patients an attempt was made to correlate the degree of histologic differentiation of the tumor with the uptake of DISIDA by the tumor. No difference in uptake could be demonstrated between well, moderately, and poorly differentiated tumors. Tc-99m DISIDA was not taken up by pulmonary metastases in the only two patients tested. We conclude that imaging with Tc-99m DISIDA in conjunction with Tc-99m colloid is of no value in the specific diagnosis of hepatocellular carcinoma.

Topics: Adult; Aged; Carcinoma, Hepatocellular; Evaluation Studies as Topic; Female; Humans; Imino Acids; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Disofenin; Tin; Tin Compounds