Importance of cholescintigraphy and inferior vena cava flow studies in the differential diagnosis of hepatocellular carcinoma.

In order to assess the usefulness of inferior vena cava flow studies and cholescintigraphy complementary to the routine static liver scintigraphy in the differential diagnosis of hepatocellular carcinoma (HCC), we studied 37 patients with a proven diagnosis of HCC and 11 patients with a liver abcess or cyst. The procedure followed was 1) a 99mTc-colloid flow study of the inferior vena cava (IVC) and iliac veins followed by static liver imaging and 2) cholescintigraphy using a dynamic acquisition mode to determine the perfusion as well as the concentration/excretion of the liver and pathological area. The hepatic perfusion index (HPI) was calculated by the "slope" method of Sarper et al.: Radiology 141:179-184 (1981) and the "area" method of Biersack et al.: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklear medizin. Erganzungsband 126:47-52 (1977). The results were compared with data previously collected in patients without liver disease (control) and other liver pathologies.