Specific considerations in the interpretation of single-photon-emission computed tomography of the normal liver

Quantitative Single Photon Emission Computed Tomography Applied to a Comparison of Propanetetraphosphonate and Albumin Colloid for Liver and Spleen Scintigraphy

A clinical application of a previously developed technique for absolute quantitation of organ uptake of radioactivity is presented. The method, which is based on single photon emission computed tomography involving correction for scattering and attenuation of photons, enables an accurate in vivo determination of the amount of administered activity taken up in a specific organ. The technique was applied to a comparative clinical trial between propanetetraphosphonate and albumin colloid for liver and spleen scintigraphy. The mean uptake of the liver was 73±9 per cent using propanetetraphosphonate and 63±10 per cent using albumin colloid. The corresponding figures for the spleen were 6±3 and 9±4 per cent, respectively. The activity concentration of the different lobes of the liver, bone marrow and soft tissue was also estimated. Phantom studies showed that the total uptake in the liver could be determined with an accuracy of about 6 per cent. The accuracy of the clinical examinations was estimated to about 10 per cent.

Change in size, shape and radiocolloid uptake of the alcoholic liver during alcohol withdrawal, as demonstrated by single photon emission computed tomography

The volume of the total liver and separate right and left lobes was studied before and after 1 week of alcohol withdrawal in 16 consecutive alcoholics by means of single photon emission computed tomography after intravenous injection of 99Tcm-human albumin colloid; the relative tissue distribution of radioactivity was also followed. The left liver lobe increased in volume more than the right lobe during drinking and decreased more rapidly after alcohol withdrawal. Median volume reductions during 1 week of alcohol withdrawal were: total liver 12%, left lobe 26%, and right lobe 8%, indicating that half of the reduction to values of a control group was achieved during this first week. The volume of the right but not of the left lobe was significantly correlated to body size in alcoholics and in controls. The left lobe had a lower capacity to concentrate the radiocolloid than the right lobe in alcoholics and in controls. The liver/spleen, liver/bone marrow and liver/background radioactivity concentration ratios in the alcoholics increased during alcohol withdrawal. We conclude that heavy drinking causes both an increased total liver volume and a change in liver shape, with a relatively more enlarged left than right lobe, as well as a decreased capacity to concentrate radiocolloid. These changes are rapidly reversible during abstinence from alcohol.