Forty-eight patients with `cold areas' on 99mTc sulphur colloid liver scintiscans were scanned again using 75Se-selenomethionine. In 11 patients with primary hepatocellular carcinoma considerable uptake of 75Se-selenomethionine could be demonstrated in the area of the tumour and uptake of 75Se-selenomethionine was also observed over extrahepatic metastases in two of these cases.
In contrast uptake was low in cholangiocellular carcinoma, Kupffer cell sarcoma, and secondary hepatic deposits (excepting melanoma metastases). No cause for the `cold area' on the 99mTc scan could be discovered in 16 of 25 patients with cirrhosis and in these patients the uptake of the two isotopes in the area of the `false positive' filling defect was almost equal. Positive identification of primary hepatocellular tumours using this dual scanning technique can be of value in determining and assessing treatment by surgery or cytotoxic therapy.
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