|
Dynamic And Static Scintigraphy In Evaluation Of Hepatic Metastases In Patients With Gastrointestinal Malignancy
İ.COŞKUN*, A.SARIKAYA**, İ.SARIKAYA***, A.TOPALOĞLU****, G.PEKİNDİL*****, T.F.ÇERMİK******, M.KAYA******, G.ALTUN******, A.ALEMDAR******, F.Gül GÜMÜŞER******
*Assoc.Prof.Trakya University, Faculty of Medicine, Department of General Surgery, EDİRNE**Asist.Prof.Trakya University, Faculty of Medicine, Department of Nuclear Medicine, EDİRNE***Asist.Prof.Kocaeli University, Faculty of Medicine, Department of Nuclear Medicine, KOCELİ****Researcher Dr.Trakya University, Faculty of Medicine, Department of General Surgery, EDİRNE*****Asist.Prof.Trakya University, Faculty of Medicine, Department of Radiology, EDİRNE******Researcher Dr.Trakya University, Faculty of Medicine, Department of Nuclear Medicine, EDİRNE
When primary or metastatic neoplasms are present in the liver, the normal patern of blood flow is distrupted and the hepatic artery supplies a larger fraction of the total flow. Static-dynamic flow scintigraphy computed tomography, ultrasound and laparotomy were performed on the 48 gastrointestinal malignancy at the begining and 2 year later. Hepatic Perfusion Index (HPI) was expressed as the ratio of arterial to total inflow and levels above 0.42 were considered to be abnormally elevated. Of 6 patients with hepatic metastases had the begining. 5 had HPI values above 0.42 and 3 had a heteregenous static scan. The sensitivities of the HPI and static scan were 83% and 50%, respectively. Of the 35 patients with no apparent hepatic metastasis at laparotomy, 16 had HPI values below 0.42 and 26 had homogenous static scan. Specifities of the HPI and static scan were 45% and 76%, respectively. Of the 35 patients without metastasis at laparotomy, 7 developed late hepatic metastasis within the following period. All patients had HPI values above 0.42 and 26 had homogenous static scan. Sensitivies and specifities for HPI and static scan were 100%, 45%, 70%, and 73%, respectively. Our results suggest that a low preoperative HPI value could reliably be used to identify patients who are at low risk of developing late liver metastasis and thus avoid unnecessary adjuvant chemotherapy.
Keywords: Static-dynamic Scintigraphy, Hepatic metastasis
Turkiye Klinikleri J Med Sci 1996, 16:391-393
|
