ABSTRACT
Focal hepatic lesion is a common problem accidentally discovered on imaging studies as abdominal ultrasonography, computed tomography and magnetic resonance imaging that must be characterized. The aim of this prospective study is to verify, the efficacy of [201]Tl-[99m]Tc.HIDA subtraction scan in detection and specification of such lesions. Seventy five patients, divided into two groups according to their definitive diagnosis, were the subject of the this work. Group 1: included 41 patients with benign focal hepatic lesions. Group 2 : included 34 patients with malignant focal hepatic lesions. All cases were diagnosed by sonography and /or tissue biopsy through true-cut needle biopsy. All of them were subjected to [201]Tl-[99m]Tc.HIDA subtraction liver scan that was interpreted both qualitatively and quantitatively. Correct diagnosis was achieved in about 80.5% and 82.4% of group 1 and 2 cases respectively using abdominal ultrasonography whereas [201]Tl-[99m]Tc.HIDA subtraction scan achieved correct diagnosis in 100% of group 2 patients. All malignant lesions appeared hot, whereas benign lesions showed no abnormality in subtraction images respectively. Moreover, [201]Tl-[99m]Tc.HIDA subtraction quantitative analysis failed to discriminate between primary and secondary hepatic focal lesions or different histopathological types or grades [P > 0.05]. [201]Tl-[99m]Tc-HIDA subtraction scan is recommended in any patient with hepatic focal lesion suspected sonographically being non-invasive, simple, easy and efficient method that can differentiate between benign and malignant focal hepatic lesions