DISTINCTION BETWEEN HEPATIC FOCAL NODULAR HYPERPLASIA AND MALIGNANT LIVER-LESIONS USING TECHNETIUM-99M-GALACTOSYL-NEOGLYCOALBUMIN

Distinction between hepatic focal nodular hyperplasia (FNH) and malign ant liver lesions is essential because of the different therapy strate gies, since FNH can be managed conservatively. The aim of this study w as to describe the imaging pattern of FNH using the hepatocyte recepto r ligand Tc-99m-galactosyl-neoglycoalbumin (Tc-99m-NGA) and to assess the value of this receptor imaging agent in the differentiation of FNH from malignant liver lesions. Methods: Twelve consecutive patients wi th histologically confirmed FNH were investigated. The FNH-lesions wer e asymptomatic and incidentally found by ultrasonography. Nine patient s with histologically verified hepatocellular carcinomas and three pat ients with liver metastases spread from gastrointestinal adenocarcinom as served as controls. Results: All FNH lesions showed normal or even increased uptake of Tc-99m-NGA. Whereas malignant liver lesion-to-norm al liver ratios amounted to 0.4 +/- 0.2 (mean +/- s.d.), FNH lesion-to -normal liver ratios were 1.7 +/- 0.3 (mean +/- s.d.). Conclusion: The receptor imaging agent Tc-99m-NGA with concurrent use of SPECT is use ful in the differential diagnosis of FNH and malignant hepatic tumors.