Differentiating hepatic abscess from tumor: combined 111In white blood cell and 99mTc liver scans

Space-occupying lesions in the liver are usually seen as photon-deficient areas on 99mTc sulfur colloid liver scans, irrespective of the underlying disease. The results of combined 111In white blood cell scans and sulfur colloid scans in three patients in whom the clinical diagnosis was either cancer or abscess are described. In the first patient, the 111In scan showed increased uptake in a region of the liver where 99mTc sulfur colloid scan showed a negative defect. Abscess was diagnosed. In the other two patients, both 111In and 99mTc scans showed cold lesions and cancer was believed to be the most likely diagnosis. These diagnoses were confirmed by biopsy. It is suggested that simultaneous white blood cell scans and sulfur colloid imaging provide additional specificity in diagnosis of hepatic masses.