technetium-tc-99m-sulfur-colloid and Hepatitis

A case of fatal radiation hepatitis occurring after treatment with 2200 rad given by the moving strip technique is presented. This fatality occurred in a 28-year-old woman with persistent ovarian carcinoma despite prolonged chemotherapy. Scans of the liver using computerized tomography, 99mTc sulfur colloid, and 99mTc diisopropyl iminodiacetic acid showed abnormalities only in sulfur colloid uptake and these resolved late in the course. Death was caused by progressive hepatic and renal failure. Postmortem examination showed changes typical of radiation hepatitis. Only 32 cases of radiation hepatitis have been previously reported and they are reviewed. The possible role of prolonged prior chemotherapy in enhancing sensitivity to radiotherapy is considered.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Autopsy; Cystadenocarcinoma; Female; Hepatitis; Humans; Hysterectomy; Ovarian Neoplasms; Radiation Injuries; Radionuclide Imaging; Radiotherapy; Radiotherapy Dosage; Technetium Tc 99m Sulfur Colloid

The anterior view of a liver-spleen scintigram performed with Tc-99m sulfur colloid was used to calculate the right-to-left (R/L) hepatic lobe ratio in three patients (acute hepatitis, normal, alcoholic cirrhosis). Emission computed tomography (ECT) was also performed, and the images correlated with the data obtained from the planar images. A low R/L hepatic lobe ratio correctly identified the patient with alcoholic cirrhosis. Streamlining of ethanol to the right (R) lobe of the liver has been suggested as the principal reason why the R/L hepatic ratio is decreased in alcoholic cirrhosis. The evaluation of the ECT images, however, suggest that the count density in each lobe of the liver is similar in the patient with alcoholic cirrhosis. The latter and known information regarding the absorption of ethanol from the gastrointestinal tract are not in agreement with the alcohol streamlining theory.

Topics: Adult; Ethanol; Female; Hepatitis; Humans; Intestinal Absorption; Liver; Liver Circulation; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Portal System; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

We compared light pen (LPEN) and Region of Interest (ROI) computer methods in determining spleen-to-liver (S/L) ratios both in anterior and posterior images in various liver diseases. The S/L ratio was independent of age or type of colloid used (equal particle size provided). Results with corresponding LPEN and ROI programs did not differ significantly from each other. The sensitivity and specificity were tested and the anterior view yielded somewhat better results than the posterior view but the best results were obtained when both projections were used. The sensitivity for all liver diseases was 60% and the corresponding specificity 93%. In hepatocellular diseases the sensitivity was 80-100%, but the S/L ration had only 37% sensitivity for hepatic metastases. Hepatomegaly in the anterior view was found in 67% of fatty liver cases, in 25% of cirrhosis cases, in 20% of hepatitis and in 25% of metastatic livers. Splenomegaly was noted in 39-54% of patients with hepatocellular diseases but only in 4-10% of metastatic diseases.

Topics: Adult; Aged; Fatty Liver; Hepatitis; Humans; Liver; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Middle Aged; Radionuclide Imaging; Spleen; Technetium; Technetium Compounds; Technetium Tc 99m Sulfur Colloid; Tin; Tin Compounds

The part played by 99Tc liver scintiscanning and laparoscopy, singly or sequentially, in the diagnosis of hepatic nodular disease was examined in a series of 316 patients. It was found that sequential employment of these two methods constituted a good diagnostic approach, since the relative sensitivity of the first could be added to the relative specificity of the second.

Topics: Cysts; Hepatitis; Humans; Laparoscopy; Liver Diseases; Liver Neoplasms; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Acute Disease; Adult; Aged; Biliary Tract; Female; Hepatitis; Humans; Imino Acids; Liver; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Sulfur Colloid; Time Factors

Topics: Biopsy; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis, Extrahepatic; Cholestasis, Intrahepatic; Hepatitis; Humans; Hyperbilirubinemia; Hyperbilirubinemia, Hereditary; Jaundice; Liver Function Tests; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Ultrasonography

Plasma lysozyme levels have been reported to reflect the functional status of the reticuloendothelial system (RES). We measured plasma lysozyme levels in 22 patients with acute hepatitis and 21 patients with cirrhosis and a mesocaval shunt. In 17 of these patients RES function was assessed by measuring the disappearance rate (t/2) of radio-labelled sulphur colloid. In acute hepatitis plasma lysozyme levels and colloid t/2 were significantly lower than in health controls and cirrhotics. In the acute hepatitis patients, the plasma lysozyme levels rose significantly two weeks after admission as the hepatitis improved. The colloid t/2 of the 17 patients with liver disease was significantly correlated with the plasma lysozyme level (r = +0.66, p = 0.005). These results suggest that in human liver disease, in comparison with animal experiments, plasma lysozyme is dependent on RES functional status in the sense that a more active RES will result in a lower lysozyme level.

Topics: Acute Disease; Adult; Aged; Female; Hepatitis; Humans; Liver Cirrhosis; Male; Middle Aged; Mononuclear Phagocyte System; Muramidase; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Liver blood flow was measured by dynamic 99Tcm-sulfur colloid accumulation and indocyanine green disappearance in 5 subjects, and by 99Tcm-sulfur colloid accumulation and 133Xe-wash-out in 7 subjects. Results obtained by the 99Tcm-sulfur colloid and indocyanine green methods were closely comparable, whereas the flow values estimated by the two isotope methods did not correlate well.

Topics: Adult; Aged; Fatty Liver; Female; Hepatitis; Humans; Indocyanine Green; Liver Circulation; Liver Cirrhosis, Biliary; Liver Diseases; Male; Methods; Middle Aged; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Xenon Radioisotopes