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December 12, 1977

Liver and Brain Scans-Reply

JAMA. 1977;238(24):2600. doi:10.1001/jama.1977.03280250026014

In Reply. —  Both questions raised by Dr Silberstein are valid. It is well known that the lateral view of liver scans may detect lesions missed by performing anterior scan alone.1,2 Only lesions larger than 2 cm located on the surface of the liver can be easily detected. The collimator, the intrinsic resolution of the detecting system, the respiratory motion of the patients, and the concurrent parenchymal liver disease can all influence the overall accuracy of liver scans. Data from the early studies from our laboratory3 do not seem to be substantially different from other series compiled recently by Brill and Patton.4 The overall accuracy of the liver scan did not appear to change substantially with the improvement of radiopharmaceuticals, instrumentation, or the use of multiple images.5 Any increase in the detection of early liver lesions when lateral scans are performed in every case is probably