technetium-tc-99m-sulfur-colloid and Carcinoma--Hepatocellular

Topics: Adult; Carcinoma, Hepatocellular; Diagnostic Imaging; Female; Humans; Liver; Liver Neoplasms; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Aged; Carcinoma, Hepatocellular; Diagnosis, Differential; Female; Focal Nodular Hyperplasia; Humans; Liver Neoplasms; Radiopharmaceuticals; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon

Analysis of the diagnostic approach and management of 20 patients with hepatocellular adenoma, 1979-1996.. University Hospital Rotterdam-Dijkzigt, Rotterdam, the Netherlands.. Retrospective and follow-up analysis.. Medical records of patients with histologically proven hepatocellular adenoma were analysed with respect to complaints, diagnostic approach and therapeutical management. Follow-up took place at the outpatient department where history-taking, physical examination, ultrasonography and hepatitis B and C serology tests were performed.. In the period 1979-1996, 20 patients with hepatocellular adenoma were treated. Eight patients (mean tumour size 3.2 cm (1.5-5)) were treated conservatively, 12 (mean tumour size 8.1 cm (6-10)) underwent hepatic resection; four because of rupture of the tumour. Serum liver enzyme values did not contribute to the diagnosis. Of the lesions 78% were diagnosed correctly by ultrasonography and 71% by computer tomography. Median follow-up of the patients treated operatively was 73 months (1-204). One patient died three years after an incomplete resection of a hepatocellular adenoma, because of a hepatocellular carcinoma. Ultrasonography did not demonstrate any recurrent tumours in the other patients. In the group of patients conservatively treated (median follow-up 39 months (24-72)) two patients died because of a hepatocellular carcinoma. Ultrasonography demonstrated stable tumour diameters in three patients and regression in three others.. Based on the literature and the presented experience surgical treatment is the treatment of choice in patients with large (> or = 5 cm diameter) hepatocellular adenomas because of the risk of malignant transformation and rupture of the tumour. With smaller tumours (< 5 cm) a conservative treatment may suffice in hepatitis virus negative patients, including withdrawal of oral contraceptives followed by thorough ultrasound follow-up of tumour size. In case of tumour growth or complaints a resection of the tumour is indicated.

Topics: Adenoma, Liver Cell; Adult; Biopsy, Needle; Carcinoma, Hepatocellular; Cause of Death; Diagnosis, Differential; Disease-Free Survival; Female; Follow-Up Studies; Humans; Liver; Liver Neoplasms; Male; Retrospective Studies; Rupture, Spontaneous; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed; Treatment Outcome; Ultrasonography

Tl-201 chloride has been used to image viable tumors in various sites of the body. There has been limited use of Tl-201 below the diaphragm because of normal uptake in the liver, spleen, kidneys, and intestines. The use of sequential Tl-201 and Tc-99m sulfur colloid in the detection and characterization of suspected hepatocellular carcinoma (HCC) was prospectively evaluated.. Four patients with indeterminate liver nodules on radiologic imaging studies were studied with sequential Tl-201 and sulfur colloid liver scans on a triple-headed gamma camera with planar and SPECT acquisition. All patients had subsequent pathologic correlation.. There were three focal nodular HCC lesions and one case of multicentric HCC, size varying between 1.9 cm and greater than 4.0 cm (multicentric HCC). In all lesions, Tl-201 SPECT images showed abnormal increased uptake at sites of HCC, which corresponded to areas of photopenia on sulfur colloid. Computed tomography detected a lesion in two of four patients, whereas US was positive in all patients. However, US was specific for tumor in only one patient and CT was not specific in any patient.. We believe that in patients with suspected HCC, Tl-201 SPECT imaging will have an important role in the detection and characterization of HCC, especially in the cirrhotic patient. Planar Tl-201 hepatic images will usually be normal, except in large lesions, and high-resolution SPECT technique is essential in successful liver tumor imaging.

Topics: Adult; Aged; Carcinoma, Hepatocellular; Child; Gamma Cameras; Humans; Intestines; Kidney; Liver; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Prospective Studies; Radiopharmaceuticals; Spleen; Technetium Tc 99m Sulfur Colloid; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Ultrasonography

The therapeutic potential of 131I-Lipiodol was investigated in 8 patients with cholangiocarcinoma (CCA) and 15 patients with hepatocellular carcinoma (HCC). Patients received one or two doses of 131I-Lipiodol via hepatic arterial injection. The mean total administered activity was 668 (SD 325) MBq in CCA and 953 (SD 477) MBq in HCC. One patient with CCA retained 131I-Lipiodol. The cumulative radiation dose was 9.6 Gy to tumour, 6.4 Gy to liver and 1.5 Gy to lung. The patient remained asymptomatic with no evidence of tumour 30 months from the start of treatment, whereas the remaining 7 patients exhibited tumour progression. The mean survival in CCA was 11.6 (SD 14.5) months. All 15 patients with HCC retained 131I with tumour: liver ratios of up to 30:1. The mean cumulative radiation dose was 34.7 (SD 32.4) Gy to tumour, 3.3 (SD 1.5) Gy to liver and 4.4 (SD 2.3) Gy to lung. The mean dose per administered activity was 3.8 (SD 4.1) cGy/MBq. Partial response (reduction in tumour size > 50%) was observed in 6 patients (40%). The mean survival was 7.1 (SD 6.0) months. 131I-Lipiodol can deliver highly selective internal irradiation to foci of HCC with evidence of objective response and may be the treatment of choice for patients with cirrhosis and a small tumour.

Topics: Adult; Aged; Carcinoma, Hepatocellular; Cholangiocarcinoma; Female; Follow-Up Studies; Gamma Cameras; Humans; Iodine Radioisotopes; Iodized Oil; Liver Neoplasms; Male; Middle Aged; Pilot Projects; Radionuclide Imaging; Remission Induction; Survival Rate; Technetium Tc 99m Sulfur Colloid; Treatment Outcome

Hepatoblastoma is a primary liver neoplasm in which prompt diagnosis and resection are critical to long-term survival. Liver scintigraphy using Tc-99m sulfur colloid and Tc-99m iminodiacetic acid (IDA) derivatives has been used in the evaluation of hepatic masses. Most space-occupying lesions of the liver appear as photopenic regions following either Tc-99m SC or IDA agents. Two exceptions have been reported. Focal nodular hyperplasia (FNH) has been shown to have variable colloid uptake, which is dependent upon the number of Kupffer cells per given volume. Many patients with FNH will demonstrate activity within the FNH to be greater or equal to the normal liver. In addition, two cases of hepatoblastoma have been reported to show colloid activity within the tumor, and in one patient slight uptake of Tc-99m IDA was noted in the tumor 15 minutes postinjection. The current case demonstrates a hepatoblastoma in which the scintigraphic findings with Tc-99m SC and Tc-99m IDA were similar to those reported, with retention of IDA far greater than the previously reported case.

Topics: Carcinoma, Hepatocellular; Diagnosis, Differential; Humans; Hyperplasia; Imino Acids; Infant; Liver; Liver Neoplasms; Male; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Carcinoma, Hepatocellular; Female; Gallium Radioisotopes; Ganglia, Sympathetic; Humans; Liver; Liver Neoplasms; Middle Aged; Pheochromocytoma; Radionuclide Imaging; Retroperitoneal Neoplasms; Technetium Tc 99m Sulfur Colloid

Dual tracer scintigraphy (DTS) (technetium 99m [99mTc] sulfur colloid and gallium 67 citrate [67 gallium citrate]) of the liver and computer subtraction studies (SS) were performed in 26 patients subsequently proven to have hepatocellular carcinoma (HCC) and 32 patients with cirrhosis and focal defects on the colloid scan, with no evidence for HCC after a complete evaluation and a 2-year follow-up period. Both DTS and SS had a sensitivity of 96% and a specificity of 90.6% for HCC. There were three false positive cases (9.4%), two of which were occult abscesses. The predictive value of a positive test was 89% and that of a negative test was 97%. The smallest tumor detected measured 2 cm in diameter and was only visualized with the SS. In the clinical setting, when HCC is suspected (a situation in which tumors are usually larger than 2 cm and the pretest probability of disease is between 20% and 60%) the DTS and SS is an excellent test for the diagnosis or exclusion of HCC. It does not appear to have a role in screening programs.

Topics: Carcinoma, Hepatocellular; False Negative Reactions; False Positive Reactions; Gallium Radioisotopes; Humans; Liver Neoplasms; Probability; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Results from ultrasonography, computed tomography (CT), scintigraphy, hepatic angiography, and magnetic resonance (MR) imaging were analyzed for five patients with surgically proved fibrolamellar hepatocellular carcinoma (FL-HCC)--a variant of hepatocellular carcinoma (HCC) that usually occurs in younger patients and has an improved prognosis and chance for curative resection. The radiologic findings were generally inconclusive for a differential diagnosis because the appearance of the lesions on the various imaging studies closely simulated that of either focal nodular hyperplasia, HCC, or metastases. CT and technetium-99m sulfur colloid scintigraphy were the most effective techniques for the workup of these lesions, but because they do not allow a definitive diagnosis, open biopsy is recommended for most lesions simulating focal nodular hyperplasia and HCC in younger patients. Although the current specificity of MR imaging in diagnosing liver lesions is low, further experience may permit more specific characterization of these lesions.

Topics: Adult; Angiography; Biopsy; Carcinoma, Hepatocellular; Female; Hepatectomy; Humans; Liver; Liver Neoplasms; Magnetic Resonance Imaging; Male; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Twenty-one patients with hepatocellular carcinoma who had gallium scans were retrospectively reviewed. Four of them demonstrated iso-intense gallium uptake compared to the adjacent liver parenchyma. The importance is therefore emphasized of using radiocolloid scan with tracer angiogram performed at the same time in order to avoid the potential diagnostic pitfall of not recognizing the tumor on gallium scan alone.

Topics: Aged; Carcinoma, Hepatocellular; Drug Evaluation; Gallium; Humans; Liver Neoplasms; Male; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid

Focal nodular liver hyperplasia (FNLH) is a benign liver tumor developing mostly in young women but occurring sometimes in men. It is often confused with other liver diseases, particularly with hepatic cell adenoma. Differential diagnosis of these diseases is very important because their prognosis and therapy are quite different. The presence of functioning Kupffer cell determined by scintigraphy with 99mTc-colloid is a decisive factor in FNLH diagnosis. However colloid accumulation was not recorded in 30-50% of patients (according to literature data), and there were cold zones on scans. 99mTc-colloid uptake can be determined by single-photon emission computed tomography.

Topics: Adult; Carcinoma, Hepatocellular; Diagnosis, Differential; Female; Humans; Hyperplasia; Imino Acids; Liver; Liver Diseases; Liver Neoplasms; Male; Organometallic Compounds; Organotechnetium Compounds; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed

Thirteen patients with a history of confirmed liver carcinoma were given either I131 goat polyclonal or murine monoclonal antibodies against alpha-fetoprotein (AFP), and then scanned with a gamma camera. In order to reduce background, nontarget activity, especially in the liver, blood pool, and reticuloendothelial system, 99mTc imaging agents were used for tumor image enhancement by computer-assisted subtraction. A sensitivity of 91% for the primary site, 50% for the lungs (33% for the chest area), and 75% for the abdomen and pelvis was achieved, with a specificity of 100%, 94%, and 100% for these sites, respectively. The accuracy was determined to be 93% for the liver, 86% for the lungs (77% for the chest), and 85% for the abdominal and pelvic area, resulting in an overall accuracy rate for imaging primary and metastatic hepatocellular cancer of 84% (90% if bone metastases are excluded). In two of the 13 patients, lesions that had been missed by conventional liver scintigraphy and transmission computed tomography (CT) were first shown by radioimmunodetection (RAID).

Topics: Abdominal Neoplasms; Adult; alpha-Fetoproteins; Antibodies; Antibodies, Monoclonal; Carcinoma, Hepatocellular; Child, Preschool; Female; Hemangiosarcoma; Humans; Image Enhancement; Image Processing, Computer-Assisted; Liver Neoplasms; Male; Pelvic Neoplasms; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms

Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

It is currently believed that hepatocellular adenoma is photon deficient on technetium-99m sulfur colloid scintigraphy because these tumors lack Kupffer cells. In a retrospective review of 13 pathologically proven cases of hepatocellular adenoma with technetium-99m sulfur colloid scintigrams, Kupffer cells were present in all 13 cases. We observed uptake of the radiocolloid by the hepatocellular adenoma in three cases (23%), and there were no histologic differences between the tumors with uptake and the ones without it. We conclude that the currently accepted reason for the lack of technetium-99m sulfur colloid uptake within hepatocellular adenoma is incorrect, and an explanation other than a lack of Kupffer cells is responsible for the photon-deficient appearance in the majority of cases of hepatocellular adenoma. Further, because hepatocellular adenoma may have technetium-99m sulfur colloid uptake in a significant percentage of cases, it should be added to focal nodular hyperplasia in the differential diagnosis of a hepatic mass with uptake by technetium-99m sulfur colloid.

Topics: Adolescent; Adult; Carcinoma, Hepatocellular; Diagnosis, Differential; Female; Humans; Hyperplasia; Kupffer Cells; Liver Neoplasms; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Sulfur Colloid

Two patients who underwent successful resections for uninodular hepatomas in non-cirrhotic livers were readmitted with late recurrences. Both had multiple imaging procedures prior to treatment including computed tomography, magnetic resonance imaging, and angiography. I recommend periodic ultrasonography and alphafetoprotein assay in the follow-up of patients who have had a hepatoma resected and I indicate when additional imaging methods are required.

Topics: Adult; Aged; Angiography; Carcinoma, Hepatocellular; Female; Gallium Radioisotopes; Humans; Liver Neoplasms; Magnetic Resonance Spectroscopy; Neoplasm Recurrence, Local; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

A case of hepatocellular carcinoma (HCC) complicated by the Budd-Chiari syndrome is described. The antemortem diagnosis of both conditions was made with the unique findings of multitracer scintigraphy. The difficulty of diagnosing these two conditions by the conventional approach is reviewed. The advantages of using multitracer scintigraphy for evaluation of hepatic lesions are also discussed.

Topics: Budd-Chiari Syndrome; Carcinoma, Hepatocellular; Humans; Liver Circulation; Liver Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

The accuracy of scintigraphy in diagnosing hepatocellular carcinoma (HCC) at Boston City Hospital between January 1, 1978 and September 30, 1983 is retrospectively reviewed. A combined protocol using technetium-99m sulfur colloid (TsSC), gallium (Ga), and scintiangiography (STA) was employed in order to enhance diagnostic specificity. There were 14 cases of HCC, of which 10 were proven histologically. The others were diagnosed clinically and angiographically. With one exception, all patients who had triple tracer scintigraphy showed a specific pattern of findings: (1) cold defects with TcSC; (2) Ga-avid foci, and (3) increased vascular supply from hepatic arteries. One false-positive study and one false-negative study were originally reported, although in both cases, strict adherence to the three criteria above would have avoided diagnostic error. These results indicate that triple tracer scintigraphy may be an effective diagnostic test for HCC. The relative efficacy of scintigraphy, ultrasonography, and computerized tomography in diagnosing HCC is also discussed.

Topics: Adult; Aged; Carcinoma, Hepatocellular; Diagnosis, Differential; Diagnostic Errors; Erythrocytes; Female; Gallium Radioisotopes; Hepatic Artery; Humans; Liver Diseases; Liver Neoplasms; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Sulfur Colloid

Twenty-three patients with hepatic cirrhosis and focal defects on Tc-99m sulfur colloid (SC) scintigrams were restudied with In-111 chloride to determine if indium localization in the focal defect is indicative of a hepatoma. Seven of eight patients with proven hepatomas had positive studies; however, six of 15 patients without hepatomas also had studies interpreted as positive. Thus, In-111 chloride is highly sensitive for the detection of hepatomas, and a negative indium study would militate against this diagnosis. The high false-positive rate found may be due to technical factors rather than a lack of specificity of localization; the experience of others seems to support this impression. At present, In-111 chloride scintigraphy for focal hepatic defects appears to be useful in ruling out hepatoma.

Topics: Carcinoma, Hepatocellular; False Positive Reactions; Humans; Indium; Liver; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Sequential liver scintiphotography with Tc-99m pyrophosphate (PYP) was used to prospectively evaluate its uptake patterns in hepatoma. The scintiphotos and time-activity curves of 40 cases were analyzed. Two distinct patterns of tumor activity were noted: gradual but complete extraction and trapping of Tc-99m PYP in hepatoma in 38% of the patients (group 1), and absence of subsequent Tc-99m PYP uptake in hepatoma after initial blood pool activity in 62% of the patients (group 2). Since extraction and trapping of Tc-99m PYP occur approximately in two fifths of the patients with hepatoma, we conclude that Tc-99m PYP liver scintigraphy is not worthwhile supplementing the conventional radionuclide studies for diagnosing hepatoma, even in the selected patients in the countries where the prevalence of hepatoma is high.

Topics: Carcinoma, Hepatocellular; Diphosphates; Humans; Liver; Liver Neoplasms; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Technetium Tc 99m Sulfur Colloid; Time Factors

Single photon emission computerized tomography coupled with Tc-99m MAA hepatic-arterial perfusion scintigraphy has been used to examine the density of the functional microcirculation of hepatic tumors relative to normal liver in 24 patients. In both colorectal and carcinoid tumors we have demonstrated an average three-fold greater arteriolar-capillary density in areas of tumor proliferation. The depth of the evoked tumor hypervascularity was found to extend about 4 cm. Tumors greater than 8-9 cm in diameter were uniformly found to have a central hypovascular core. These observations are of importance in the design of selective strategies utilizing therapeutic microspheres directed against the hypervascular proliferating regions of human tumors.

Topics: Adult; Aged; Biopsy; Carcinoid Tumor; Carcinoma, Hepatocellular; Colonic Neoplasms; Female; Humans; Liver Neoplasms; Male; Microcirculation; Middle Aged; Particle Size; Serum Albumin; Sulfur; Technetium; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed

Based on strict predefined histologic criteria, we identified 23 patients with hepatic adenoma and 41 patients with focal nodular hyperplasia seen at this institution between 1961 and 1980. Patients with hepatic adenoma were young and 91% were female. When a reliable history was available, 89% had used oral contraceptives; 53% presented acutely or with pain. Eleven of 11 radionuclide scans were abnormal; 15 of 15 angiograms showed a hypervascular mass with 7 of 15 showing areas of hypovascularity. Eighteen resections were performed with one operative death. Two tumors contained areas of unequivocal hepatocellular carcinoma. Fifteen of 18 patients followed for 82 +/- 11 mo were living and well and had discontinued oral contraceptives. Focal nodular hyperplasia patients were older, 88% were female, and 58% had used oral contraceptives. Their lesions were discovered accidentally. Seven of 12 radionuclide scans demonstrated voids, while 13 of 13 angiograms showed hypervascular lesions with no areas of hypovascularity. Seventeen tumors were resected. Twenty-three of 24 patients followed for 45 +/- 7 mo were living and well. One died of nonhepatic causes. Based on the findings of this review, we believe that if the clinical suspicion of hepatic adenoma or focal nodular hyperplasia is strong, elective laparotomy for diagnosis is usually the best approach. Hepatic adenoma should be resected if technically feasible. Intraoperative wedge biopsy is appropriate for focal nodular hyperplasia.

Topics: Abdomen; Adult; Biopsy; Carcinoma, Hepatocellular; Contraceptives, Oral; Diagnostic Techniques, Surgical; Female; Humans; Hyperplasia; Liver; Liver Neoplasms; Male; Middle Aged; Pain; Palpation; Prognosis; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Adenoma, Bile Duct; Adult; Carcinoma, Hepatocellular; Female; Gallium Radioisotopes; Humans; Imino Acids; Liver Neoplasms; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid

The difficulty of clinical and radiographical diagnosis of hepatoma is discussed. A case of hepatoma is reported. Both the primary tumor and distant metastases showed strong avidity for 99mTc-HIDA, which normally is concentrated by parenchymal cells of the liver. The potential of using 99mTc-HIDA for the noninvasive investigation of patients suspected of having hepatoma is discussed. The association between tumor avidity for 99mTc-HIDA and the bile-forming ability of tumor cells is of interest.

Topics: Adult; Carcinoma, Hepatocellular; Diagnosis, Differential; Gallium Radioisotopes; Hemangioma; Humans; Imino Acids; Iodine Radioisotopes; Liver; Liver Neoplasms; Lung Neoplasms; Lymphoma; Male; Radionuclide Imaging; Rose Bengal; Sulfur; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Twenty-nine small (less than 5 cm) hepatocellular carcinomas in 18 patients were examined by radionuclide imaging (RN), ultrasound (US), computed tomography (CT), hepatic angiography, and serum alpha 1-fetoprotein (AFP) assay. Sensitivity was 39% with RN, 50% with US, 56% with CT, and 94% with angiography, including infusion hepatic angiography (IHA). Lesions larger than 3 cm could be detected by all of these methods; those between 2 and 3 cm were generally shown by US and CT but not RN. IHA was essential for diagnosis of lesions less than 2 cm, which were otherwise difficult or impossible to detect except with angiography. As a screening method, AFP was best, followed by US and CT. The authors recommend using AFP and US to minimize expense and radiation exposure. In questionable cases, IHA should be performed.

Topics: Adult; Aged; alpha-Fetoproteins; Angiography; Carcinoma, Hepatocellular; Diatrizoate Meglumine; Female; Humans; Liver Neoplasms; Male; Middle Aged; Retrospective Studies; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

This prospective study of 80 patients compared the results of liver scintiscan, ultrasound, and CT scan to the objective findings recorded at laparotomy. Analysis of these data revealed no significant differences in sensitivity, specificity, or accuracy among these three imaging procedures, although a trend toward increased accuracy of the CT scan was noted. In a composite analysis, the accuracy was not improved by combining two or all three of these examinations. A lesion by lesion analysis revealed the inability of any of the three currently used techniques to accurately detect lesions less than 3 cm in diameter.

Topics: Biopsy; Carcinoma, Hepatocellular; Evaluation Studies as Topic; False Positive Reactions; Humans; Liver Neoplasms; Prospective Studies; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Topics: Adult; Aged; Carcinoma, Hepatocellular; Colloids; Cysts; Female; Hemangioma; Humans; Liver Abscess; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Male; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Carcinoma, Hepatocellular; Child; Child, Preschool; Female; Humans; Hyperplasia; Liver; Liver Neoplasms; Male; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Adult; Carcinoma, Hepatocellular; Colloids; Female; Humans; Liver Neoplasms; Neoplasms, Multiple Primary; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Adolescent; Adult; Carcinoma, Hepatocellular; Child; Glycogen Storage Disease Type I; Hepatomegaly; Humans; Liver Neoplasms; Male; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Ultrasonography

Liver subtraction scans using 99Tcm sulphur coloid and 75Se-selenomethionine were carried out in 58 patients with suspected hepatoma. Of the 18 patients with hepatoma proven by histology, 16 showed selective concentration of selenomethionine in the tumour, giving a true positive rate of 89%. Of the 40 patients who did not have hepatoma, 32 scans showed no evidence of selective concentration of selenomethionine, giving a true negative rate of 80%. The false positive rate was 8% in non-cirrhotic patients with focal disease, but 55% in patients with cirrhosis. It is concluded that combined scanning with this technique is useful in non-cirrhotic patients in distinguishing hepatoma from other causes of focal disease, but that the technique is not useful and frequently misleading in patients with cirrhosis.

Topics: Carcinoma, Hepatocellular; Diagnosis, Differential; False Positive Reactions; Humans; Liver Diseases; Liver Neoplasms; Radioisotopes; Radionuclide Imaging; Selenium; Selenomethionine; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid