title: Variable uptake feature of focal nodular hyperplasia in Tc-99m phytate hepatic scintigraphy/single-photon emission computed tomography-A parametric analysis.
abstract: Tc-99m phytate hepatic scintigraphy remains the standard method for evaluating the functional features of Kupffer cells. In this study, we demonstrate the variable uptake feature of focal nodular hyperplasia (FNH) in Tc-99m phytate scintigraphy. We reviewed all patients who underwent Tc-99m phytate hepatic scintigraphy between 2008 and 2012 in Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Cases with FNH were diagnosed on the basis of pathology or at least one or more prior imaging with a periodic clinical follow-up. All patients received a standard protocol of dynamic flow study and planar and Tc-99m phytate single-photon emission computed tomography (E. CAM; Siemens). The correlation of variable nodular radioactivity with parameters such as tumor size and localization was analyzed. In total, 15 lesions of 14 patients in the clinic were diagnosed as FNH. The tumor size was approximately 2.9-7.4 cm (mean size 4.6 cm). Four lesions were larger than 5 cm. The major anatomic distribution was in the right hepatic lobe (10 lesions), particularly in the superior segments (7 lesions). Tc-99m phytate single-photon emission computed tomography imaging for determining the functional features of Kupffer cells included cool/cold (8 lesions), isoradioactive/warm (6 lesions), and hot (1 lesion) patterns of uptake. We did not observe any statistically significant correlation between variable nodular radioactivity and tumor size (p=0.68) or localization (p=0.04). Herein, we demonstrate the variable uptake feature of FNH in Tc-99m phytate scintigraphy. In small FNH tumors (< 5 cm), increased or equal uptake still provided specificity for the differential diagnosis of hepatic solid tumors.
authors.affiliation: Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Hsu
authors.affiliation: Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: uych@kmu.edu.tw.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Yang
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Public Health College of Health Science, Kaohsiung Medical University, Taiwan.
authors.forename: Yun-Chang
authors.initials: YC
authors.lastname: Lai
authors.affiliation: Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Shinn-Cherng
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Zu-Yau
authors.initials: ZY
authors.lastname: Lin
mesh_terms: D000328:Adult; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics*; D010833:Phytic Acid / Q000493:pharmacokinetics*; D011851:Radioactivity; D011877:Radionuclide Imaging; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
chemical_list: D015609:Organotechnetium Compounds; C026177:technetium phytate; D010833:Phytic Acid
keywords: Focal nodular hyperplasia; Kupffer cells; Tc-99m phytate scintigraphy/single-photon emission computed tomography