Selenomethionine liver scanning in the diagnosis of hepatoma

Liver subtraction scans using 99Tcm sulphur coloid and 75Se-selenomethionine were carried out in 58 patients with suspected hepatoma. Of the 18 patients with hepatoma proven by histology, 16 showed selective concentration of selenomethionine in the tumour, giving a true positive rate of 89%. Of the 40 patients who did not have hepatoma, 32 scans showed no evidence of selective concentration of selenomethionine, giving a true negative rate of 80%. The false positive rate was 8% in non-cirrhotic patients with focal disease, but 55% in patients with cirrhosis. It is concluded that combined scanning with this technique is useful in non-cirrhotic patients in distinguishing hepatoma from other causes of focal disease, but that the technique is not useful and frequently misleading in patients with cirrhosis.