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December 12, 1977

Liver and Brain Scans

JAMA. 1977;238(24):2600. doi:10.1001/jama.1977.03280250026013

To the Editor.—  The questions raised by the article "Indication for Liver and Brain Scans" by Wittes and Yeh (238: 506, 1977) are important ones. However, their methods appear inadequate for both liver and brain scans and should result in a number of false-negative tests. This, of course, would change the results and conclusions completely.Specifically, liver scanning should include a right lateral view at all times, since we have seen many cases in which this view provided the only clue to the presence of metastatic lesions. This is explained by the fact that the liver is a large organ, and foci of tumor located midway between the anterior and posterior surfaces may be missed on anterior and posterior scanning, as normal tissue surrounding a small tumor and emitting a high flux of γ rays may make detection of a "cold" spot difficult unless it is large.More importantly with