Uptake of Tc-99m di-isopropyliminodiacetic acid by hepatocellular carcinoma: concise communication.

Uptake of Tc-99m di-isopropyliminodiacetic acid (DISIDA) by hepatocellular carcinoma was assessed in 30 patients showing obvious liver defects on a Tc-99m tin colloid image. In none of these patients was there complete "filling in" of the defects, and even partial "filling in" occurred in only 11 (36.7%). There was no uptake of Tc-99m DISIDA by the primary tumor in the remaining 19 patients (63.3%). In 19 of the 30 patients an attempt was made to correlate the degree of histologic differentiation of the tumor with the uptake of DISIDA by the tumor. No difference in uptake could be demonstrated between well, moderately, and poorly differentiated tumors. Tc-99m DISIDA was not taken up by pulmonary metastases in the only two patients tested. We conclude that imaging with Tc-99m DISIDA in conjunction with Tc-99m colloid is of no value in the specific diagnosis of hepatocellular carcinoma.

Demonstration of post-traumatic bile leak using technetium-99m DISIDA.

A 25-year-old miner was admitted with an acute abdomen and marked pallor following a crush injury to the abdomen. CT showed an irregular, patchy appearance of the posterosuperior portion of the liver with a coefficient of density appreciably less than the rest of the liver, consistent with the presence of a hepatic hematoma. The patient was treated conservatively. During the two weeks that followed, fluid accumulated in the peritoneal cavity. At laparotomy, a large volume of bile- and blood-stained fluid was found in the peritoneal cavity. Tc-99m DISIDA imaging was done after laparotomy.

Radiocolloid liver imaging in tuberculous hepatitis.

Twenty of 22 patients with tuberculous hepatitis had abnormal Tc-99m tin colloid liver scans. However, in the majority of the patients the changes were mild and nonspecific. The most frequent scintigraphic picture was a decreased uptake of the radiocolloid by the liver, with shunting to the spleen and bone marrow. The decreased hepatic uptake was usually mildly heterogeneous, but it was sometimes homogeneous, and in five patients obvious defects were present. The liver was enlarged in six patients and the spleen in six patients. Increased extrahepatic uptake of the radiocolloid was the only abnormality in five patients. The severity of the scintigraphic changes did not correlate with the following histologic findings: number of granulomas, degree of associated fibrosis, degree of hepatocyte swelling, or extent of fatty change.

The clinical value of scintigraphic brain scanning. Experience at the Hillbrow Hospital, Johannesburg, South Africa.

Patients were referred to the Department of Nuclear Medicine for brain scintigraphy to be screened for possible intracranial pathology. These referrals were made in order to reduce the heavy load on the transmission computerized tomography (TCT) facilities. Great clinical importance, therefore, has been attached to scintigraphic findings; this emphasizes the need for an accurate assessment of the predictive value of this procedure.

Technetium-99m glucoheptonate as a scanning agent in hepatocellular carcinoma.

Technetium-99m glucoheptonate (Tc-99m GH) is concentrated in pulmonary and cerebral tumors. The purpose of this study was to assess the uptake of this radionuclide by hepatocellular carcinoma. Its concentration by the primary tumor was compared with that in the non-neoplastic hepatic tissue in 31 patients who showed obvious defects on a colloid scan, and its uptake by pulmonary metastases was examined in six patients with x-ray evidence of this complication. In two patients, the uptake by the tumor was greater than, in six it was equal to, and in ten it was less than that in the non-neoplastic hepatic tissue. In the remaining 13 patients, there was no concentration at all in the tumor. In none of the six patients with multiple pulmonary metastases could uptake of Tc-99m GH by the metastases be demonstrated. It is concluded that Tc-99m GH is of limited value in the diagnosis of primary or metastatic hepatocellular carcinoma.

The use of technetium-99m-di-isopropyl-iminodiacetic acid imaging in the demonstration of a biliary-bronchial fistula.

A case is described in which technetium-99m-di-isopropyl-iminodiacetic acid imaging was used to trace the passage of bile from its site of leakage into an amoebic liver abscess, through a fistulous tract connecting the liver abscess with an abscess in the right lower lobe of the lung, and into the upper respiratory tract.

A patient data storage and retrieval system.

A patient data storage and retrieval system has been developed for a microcomputer used in a nuclear medicine department. The advantages of coding clinical information and the problems encountered in coding are highlighted. The application of the stored patient data is briefly discussed.