Optimizing the clinical value of hepatic scintiphotography

Hepatic scintiphotography serves as a highly useful anatomic liver function test. When the descriptive features of the liver scan are carefully related to underlying pathology, the resulting data base permits a detection sensitivity of 90% for metastatic cancer and for the diffuse parenchymal diseases. The consequences of false positive (FP) interpretations for patient care must be minimized by attention to perceptual and technical details, by incorporating other tests into the evaluative algorithm, and by knowledge of the distribution of diseases in the population examined. The liver scan would be more beneficially applied to patient management if referring physicians were made aware of its capabilities. They, in turn, must develop more explicit strategies for disease management in order that scintiphotography be effectively applied in clinical decision making.