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August 4, 1969

Detection of Hepatic Neoplasm: Hepatic Scanning Combined With Liver-Function Studies

Author Affiliations

From the Department of Medicine (MAJ Wilson and COL Overholt) and the Radioisotope Clinic (Dr. Preston), Fitzsimmons General Hospital, Denver. MAJ Wilson is now with the Department of Medicine, US Army Hospital Specialized Treatment Center, Fort Gordon, Ga; Dr. Preston is with the Department of Radiology, University of Kentucky, Lexington; and COL Overholt is with the Gunderson Clinic, La Crosse, Wis.

JAMA. 1969;209(5):676-679. doi:10.1001/jama.1969.03160180022006

In 69 patients, hepatic scans with gold Au 198 and determinations of serum alkaline phosphatase (SAP) levels were 78% accurate (in 14 of 18 patients) and 80% accurate (in 12 of 15), respectively, in detecting hepatic neoplasm and 93% accurate (in 14 of 15) when used together. When results of both studies were normal, hepatic neoplasm was present in 4% (one of 23 patients). The likelihood of hepatic neoplasm in the presence of a positive scan and elevated SAP level was 92% (in 11 of 12). No liver-function studies were helpful in eliminating the problem of false-negative scans. The presence of multiple space-occupying lesions without associated increased extrahepatic uptake was effective in differentiating hepatic neoplasm from cirrhosis. In 11 patients with lymphoma, increased splenic uptake of gold Au 198 occurred in seven. In some instances, this may have been related to hepatic involvement with lymphoma, and, in others, to increased phagocytic activity of the reticuloendothelial system of the spleen with or without splenomegaly.