A study of filling defects in the liver and spleen with multiple radionuclides

Studies were made to determine if examination with multiple radiopharmaceuticals would improve the sensitivity and specificity of colloid liver spleen scans. Increased uptake of Ga-67 citrate and In-111 bleomycin was found in most Tc-99m sulfur colloid scan defects caused by hepatocellular hepatoma or lymphoma. Increased uptake of these agents was found in some defects caused by malignant melanoma, breast carcinoma and carcinoma of the lung, and was rarely seen in defects caused by cholangiocarcinoma or gastrointestinal neoplasms. Gallium was useful in the followup of patients with hepatoma. Procedures designed to evaluate the gall bladder fossa, renal impression, or blood pool activity of an apparent tumor were found to be helpful and simple to perform. Iodine-131 as NaI was useful in studying functioning liver metastases from thyroid carcinoma as were bone scanning agents in evaluating hepatic metastases from osteogenic sarcoma. Multiple radiopharmaceutical evaluation of the physiologic and biochemical characteristics of liver lesions supplements current radiologic examinations and increases diagnostic specificity.