The role of radionuclide imaging in disease of the alimentary tract

The current status of radionuclide imaging studies of the liver, spleen, and pancreas is reviewed. Although current instrumentation and radiopharmaceuticals allow considerably better images than in the past, the overall accuracy of detecting liver metastases remains at 80%. The specificity of detecting hepatic space occupying disease has been enhanced by additional radonuclide studies which reveal the vascular and metabolic properties of the lesion.-The frequency of spleen imaging has increased since^99mTc-labeled colloids have been used. In most instances, it is obtained as a coincidental portion of the liver scintigraphic examination although it has significant primary indicxations such as in the elucidation of masses in or trauma to the left upper quadrant of the abdomen.-Selenium-75 selenomethionine pancreatic scintigraphy is best performed with serial Anger Camera images. Interfering hepatic activity is best removed by electronic subtraction techniques; if available. Careful attention to patient selection for the procedure is important. The mean true-positive and negative rates are 86% and 20%, respectively.