Distribution of the extrahepatic uptake in liver diseases as recorded by scintigraphy

Liver scintigraphy performed with 99Tcm-S and Sn colloid ought to be named RES scintigraphy as the distribution of the colloid is mainly determined by the phagocytic capacity of the RES but also by the regional blood flow and the features of the colloid. Both diffuse hepatocellular disease and malignant disease may have decreased activity in the liver and increased extrahepatic activity: spleen, bone marrow and lungs. In liver cirrhosis at least 3 types of distribution of activity can be recognized: (a) equal increase in spleen, bone marrow and lungs, (b) mainly increase in spleen, and (c) mainly increase in bone marrow and lungs. Therefore a ratio between the total extrahepatic and the hepatic activity ought to be calculated rather than a spleen/liver ratio.