title: Diagnostic pharmaco-scintigraphy with hepatic intra-arterial technetium-99m macroaggregated albumin in the determination of tumour to non-tumour uptake ratio in hepatocellular carcinoma.
abstract: Between October 1990 and March 1993, 124 patients who had hepatocellular carcinoma (HCC) underwent diagnostic pharmaco-scintigraphy with hepatic intraarterial technetium-99m macroaggregated albumin (TcMAA) to determine the tumourous to non-tumourous liver tissue uptake ratio (T/N ratio). There were 110 males and 14 females. Ages ranged from 16 to 73 with a median of 55 years. The range of T/N ratio was 0.7 to 19.3 with a median of 3.8. 12 patients with inoperable HCC were subsequently selected by predetermined criteria to undergo treatment with hepatic intraarterial yttrium-90 microspheres and the T/N ratios in these patients were validated by beta probe dosimetry and liquid scintillation count of multiple liver biopsies. The T/N ratio determined by preoperative diagnostic TcMAA scan correlated well with intraoperative beta probe dosimetry, with coefficient of correlation r = 0.82. Preoperative TcMAA scan also correlated well with liquid scintillation count of biopsy specimens, with r = 0.96. We conclude that TcMAA scan can be used to determine the T/N ratio in patients with HCC, thus allowing better selection of patients with inoperable tumours for loco-regional therapy.
authors.affiliation: Joint Hepatocellular Carcinoma Study Group, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
authors.forename: W Y
authors.initials: WY
authors.lastname: Lau
authors.forename: T W
authors.initials: TW
authors.lastname: Leung
authors.forename: S
authors.initials: S
authors.lastname: Ho
authors.forename: M
authors.initials: M
authors.lastname: Chan
authors.forename: N W
authors.initials: NW
authors.lastname: Leung
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.forename: C
authors.initials: C
authors.lastname: Metreweli
authors.forename: A K
authors.initials: AK
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins / Q000493:pharmacokinetics; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013668:Technetium Tc 99m Aggregated Albumin / Q000493:pharmacokinetics
chemical_list: D000418:Albumins; D013668:Technetium Tc 99m Aggregated Albumin; C075321:macro aggregates of albumin