Directions in radionuclide hepatobiliary imaging

The 99mTc iminodiacetic acid analogues are a group of radiopharmaceuticals which are rapidly metabolized by the hepatocytes and excreted into the biliary tract. In essence, they function as bile markers and are therefore used to trace bile flow pathways by external imaging. There are various facets of liver and biliary tract disorders which can now be investigated with these new agents at a greater confidence level than heretofore possible with the older test agent, 131I-rose bengal. These include determination of cystic duct patency, assessment of the integrity of surgically altered biliary and gastrointestinal anatomy, disclosure of biliary gastric reflux, and distinction between medical and surgical jaundice.