Radionuclide imaging in hepatobiliary disease

: Presently, radionuclide imaging in hepatobiliary disease is mainly used to evaluate the functional aspect in hepatobiliary disease. For the evaluation of hepatic function, three kinds of radiopharmaceuticals are now commercially available: these are the Kupffer-cell oriented radiotracer of 99mTc-colloid, the hepatocyte oriented radiotracer of 99mTc-PMT, and the receptor-binding radiopharmaceutical of 99mTc-GSA. These radiopharmaceuticals must be properly used, according to the purposes. 99mTc-PMT can be used to determine the degree of functional disorder in acute hepatic disease and evaluate the severity of diffuse hepatic disease, whereas 99mTc-colloid can effectively evaluate the potential etiology of the disease process and its chronicity. And 99mTc-GSA may also be used to evaluate the severity of the disease. In particular, the hepatic functional reserve must be evaluated with 99mTc-GSA. The biliary patency from the intrahepatic bile canaliculi to the common bile duct can be effectively evaluated with 99mTc-PMT. The diagnosis of acute cholecystitis is most reliably made by radionuclide imaging. And radionuclide imaging is sometimes to be used for the differentiation of cholestasis. In particular, the discrimination among the disease entities of chronic intermittent intrahepatic cholestasis including primary biliary cirrhosis, primary sclerosing cholangitis and juvenile intrahepatic bile duct hypoplasia can be made. Moreover, it is also be used in evaluating constitutional hyperbilirubinemia, biliary leakage, infantile jaundice and gallbladder or syphinctor Oddi motor dysfunction.