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Hepatic Scintigraphy in Clinical Decision Making

Harvard Medical School and Peter Bent Brigham Hospital, Boston, Massachusetts

Correspondence: For reprints contact: David E. Drum, Div. of Nuclear Medicine, Shields Warren Radiation Laboratory, 50 Binney St., Boston, Mass. 02115.

ABSTRACT

The results of 650 liver scintiscans performed in a university teaching hospital have been analyzed with the aim of relating scintigraphic appearance to clinicopathological disease in the context of diagnostic management. Hepatic scintigraphy detected the presence of parenchymal, focal, or infiltrative disease with 90% accuracy. The various possible scintigraphic abnormalities, while by no means histologically diagnostic, occurred with probabilities distinctive for each disease category. Analysis of these data and the sources of erroneous interpretations in the light of signal detection theory leads to the conclusion that the pattern-reading methodology may inherently preclude further uncompensated improvement in a single aspect of clinical performance. This conclusion is supported by accuracy data already on record and it suggests that development of disease specific radiopharmaceutical agents merits high priority in research planning.

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