[Diagnosis of liver tumors--when is scintigraphy of value?]

This paper illustrates the importance of utilizing radionuclide techniques to characterize in vivo benign liver masses. Examining the physiologic tumor function cholescintigraphy offers a highly specific pattern for identifying focal nodular hyperplasia (FNH): hypervascularisation, hepatocellular uptake and impaired transport of the bilirubin like tracer documented as trapping in later images. An hemangioma is diagnosed with high probability in case of a positive bloodpoolscintigraphy. But false-positive results have been reported. Therefore, a second unrelated examination, e.g. ultrasound, magnetic resonance imaging or dynamic computerized tomography is necessary to establish this diagnose in a sufficient certainty. If complications due to tumor growth are not expected, both, FNH and hemangioma need no further therapy. High sensitivity is necessary to establish resectability or tumor spread. Scintigraphic techniques are advantageous in scanning completely the whole body. On the other hand, there are limitations as low resolution and anatomical orientation, low specific activity in the tumor and artificial activity near by the tumor. To measure therapy effects and to detect recurrencies especially in borderline-cases positron emission computed tomography (PET)-technology is recommended, because PET offers a specific-parametric evaluation.