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September 14, 1984

Diagnosis of Metastatic Liver Cancer

Author Affiliations

O'Connor Hospital San Jose, Calif

JAMA. 1984;252(10):1279-1280. doi:10.1001/jama.1984.03350100013010

To the Editor.—  The Jan 13, 1984, issue of The Journal contains favorable statements concerning the efficacy of radionuclide scans. The article by Dr Silberstein1 is a little biased in favor of nuclear medicine.What is needed to document the reliability of this diagnostic technique and its efficacy compared with alternative diagnostic methods are prospective comparative studies involving the modalities in question. There are few published prospective comparative studies. Among the best known, in Europe, is the Belgian study by Mulder et al.2 One hundred patients with carcinoma of the digestive tract had a computed tomographic (CT) scan and a radionuclide liver scan prior to operation. Both were reported to have the same degree of diagnostic reliability (about 80% correct diagnosis).Among the American studies, the better known are the Harvard series by Alderson et al3 and the Roswell Park study by Temple et al.4 In