Simultaneous 99mTc-P-butyl-IDA and 131I-rose bengal scintigraphy in neonatal jaundice

Eight neonates with jaundice were studied simultaneously with 99mTc-p-butyl-IDA and 131I-rose bengal. Due to physical decay, 99mTc-p-butyl-IDA failed to demonstrate delayed excretion through the patent extrahepatic biliary tract in 3 of 5 patients with concomitant hepatitis; 131I-rose bengal showed small-bowel activity in all 5. Neither agent demonstrated small-bowel activity in 3 neonates with extrahepatic biliary atresia. Based on this clinical trial, 131I-rose bengal remains the radiopharmaceutical of choice for distinguishing between hepatitis and biliary atresia in these patients.