DIAGNOSTIC OF LIVER-TUMORS - WHEN ARE RAD IONUCLIDE METHODS OF IMPORTANCE

This paper illustrates the importance of utilizing radionuclide techni ques to characterize in vivo benign liver masses. Examining the physio logic tumor function cholescintigraphy offers a highly specific patter n for identifying focal nodular hyperplasia (FNH): hypervascularisatio n, hepatocellular uptake and impaired transport of the bilirubin like tracer documented as trapping in later images. An hemangioma is diagno sed with high probability in case of a positive bloodpoolscintigraphy. But false-positve results have been reported. Therefore, a second unr elated examination, e. g. ultrasound, magnetic resonance imaging or dy namic computerized tomography is neccessary to establish this diagnose in a sufficient certainity. If complications due to tumor growth are not expected, both, FNH and hemangioma need no further therapy. High s ensitivity is neccessary to establish resectability or tumor spread. S cintigraphic techniques are advantageous in scanning completly the who le body. On the other hand, there are limitations as low resolution an d anatomical orientation, low specific activity in the tumor and artif icial activity near by the tumor. To measure therapy effects and to de tect recurrencies especially in borderline-cases positron emission com puted tomography (PET)-technology is recomended, because PET offers a specific-parametric evaluation.