Increased Specificity of Liver Scanning with the Use of⁶⁷Gallium Citrate

Sixty-one patients with focal defects on colloid liver scan and two with infrahepatic mass lesions were studied with 67gallium citrate. Definite accumulation of the radionuclide was noted in the lesions of 23 of 30 patients with hepatic cancer –11 of 12 with hepatocellular carcinoma, four of nine with metastatic adenocarcinoma, two with squamous-cell carcinoma, two with malignant melanoma, two with Hodgkin's disease, one with undifferentiated carcinoma and one with hepatoblastoma. The tracer was poorly taken up by five metastatic adenocarcinomas and one malignant carcinoid. Four of six patients with liver abscess and one with cirrhosis also had appreciable accumulation of gallium in the liver lesions. Twenty-six other patients with benign conditions producing focal defects on the colloid liver scan did not have appreciable uptake of gallium. The gallium studies were helpful in the detection of hepatoma in patients with cirrhosis and in differentiating cancer and abscess from more benign causes of an abnormal liver scan.