SCINTIGRAPHIC TECHNIQUES FOR HEPATIC IMAGING : Update for 2000 - 09/09/11
Résumé |
Nearly a decade ago, I wrote an article for The Radiologic Clinics of North America on the status of hepatic and hepatobiliary scintigraphy for the 1990s.4 Now, I have been asked to provide an update on hepatic scintigraphy as we approach the new millennium. If asked years ago to predict the interval change, I would have predicted little new to report. Hepatic scintigraphy has had a diminishing role in patient care over the last several decades. As always, predictions are difficult, and I would have been wrong. The changes in hepatic scintigraphy have been fairly prominent, and these changes somewhat mirror an evolution that is occurring in all of nuclear medicine. In the past, we had tests that gave relatively nonspecific results, but would be applied to broad patient populations (e.g., the old liver-spleen scan used to screen for metastatic disease). Now, we have tests with much more specific results that apply to a very select patient group (e.g., somatostatin imaging in the gastrinoma patient). Do I dare to predict the future again? This trend will continue as more specific methods of lesion detection are developed.
The trend in equipment is in the opposite direction. Imaging equipment with very specific functions makes cost-efficient practice more difficult. Positron emission tomography (PET) scan has been a tremendous research tool for over 30 years, but has had a hard time making a shift from the research laboratory to the clinical environment. Why such a hard time? The answer boils down to money. As a single-use, very expensive piece of equipment, installed with a cyclotron to produce its imaging agents, PET scan is a very expensive venture. In order to reduce the cost of imaging positron agents, single photon emission CT (SPECT) scan has been modified to image high-energy photons and hybrid imaging devices capable of both routine nuclear medicine imaging and coincidence imaging of positron-emitters have been developed. This area remains one of extreme controversy.3, 5, 6 I try, however, to present an objective view of the issue of PET scan and hybrid PET scan–like approaches to liver imaging.
Overall, the changes over the last several years in hepatic scintigraphy can be summed up by one of two trends: (1) the development and increased availability of new imaging agents and (2) the development of new imaging equipment. I give a rapid, realistic assessment of standard hepatic scintigraphy and then discuss each of these two trends.
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| Address reprint requests to Walter E. Drane, MD, Division of Nuclear Medicine, Department of Radiology, University of Florida, Box 100374, JHMHC, 1600 SW Archer Road, Gainesville, FL 32610–0374 |
Vol 36 - N° 2
P. 309-318 - mars 1998 Retour au numéro
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- ULTRASONOGRAPHY : Update on Liver Technique
- Patricia L. Abbitt
- BENIGN LESIONS OF THE LIVER
- Patricia J. Mergo, Pablo R. Ros
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