Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed Imaging

Hepatobiliary radionuclide imaging is typically performed to detect cholecystitis. Infrequently, imaging reveals an obstructive pattern. Although delayed hepatobiliary imaging is commonly used to differentiate between intrahepatic (IH) and extrahepatic (EH) obstruction in the newborn; there is room...

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Main Authors: Robert Matthews, Mera Goodman, Pryanka Relan, Elham Safaie, Dinko Franceschi
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2013-04-01
Series:World Journal of Nuclear Medicine
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.136692
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author Robert Matthews
Mera Goodman
Pryanka Relan
Elham Safaie
Dinko Franceschi
author_facet Robert Matthews
Mera Goodman
Pryanka Relan
Elham Safaie
Dinko Franceschi
author_sort Robert Matthews
collection DOAJ
description Hepatobiliary radionuclide imaging is typically performed to detect cholecystitis. Infrequently, imaging reveals an obstructive pattern. Although delayed hepatobiliary imaging is commonly used to differentiate between intrahepatic (IH) and extrahepatic (EH) obstruction in the newborn; there is room to clarify the use of delayed imaging in the adult population. A retrospective review was performed of adult patients demonstrating a complete obstructive pattern on initial Tc-99m mebrofenin hepatobiliary imaging. Delayed imaging was divided into early delayed (ED) (<10 h) and late delayed (LD) (≥10 h) imaging. Two physicians qualified the presence of intestinal radiotracer (negative, low to high) on delayed images. Determination of EH or IH pathology was obtained from chart review. A total of 24 patients demonstrated an obstructive pattern using delayed Tc-99m mebrofenin hepatobiliary imaging, with delayed imaging ranging from 4 to 30 h. EH pathologies (choledocholithiasis, stricture, other) represented 63% of cases (n = 15), IH pathologies (cirrhosis, hepatitis, other) represented 33% cases (n = 8) and 1 case was indeterminate. 67% of EH cases showed intestinal activity on delayed imaging (67% on ED and 67% on LD imaging), whereas 63% of IH cases showed intestinal activity on delayed imaging (67% on ED imaging and 60% on LD imaging). The presence of intestinal activity on the both the early and delayed images did not differentiate between the IH and EH pathology groups. Subdividing the groups into ED imaging and LD imaging was also not predictive of determining location of obstructive pattern on the initial 1 h of imaging. This data suggests that delayed hepatobiliary scintigraphy has little or no role in determining the cause of obstructive pathology.
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spelling doaj-art-2c54faa4b3a44791a459217afffcae882025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122013-04-011202545610.4103/1450-1147.136692Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed ImagingRobert Matthews0Mera Goodman1Pryanka Relan2Elham Safaie3Dinko Franceschi4Department of Radiology, Stony Brook University Medical Center, Stony Brook, NY, United States of AmericaDepartment of Radiology, Stony Brook University Medical Center, Stony Brook, NY, United States of AmericaDepartment of Radiology, Stony Brook University Medical Center, Stony Brook, NY, United States of AmericaDepartment of Radiology, Stony Brook University Medical Center, Stony Brook, NY, United States of AmericaDepartment of Radiology, Stony Brook University Medical Center, Stony Brook, NY, United States of AmericaHepatobiliary radionuclide imaging is typically performed to detect cholecystitis. Infrequently, imaging reveals an obstructive pattern. Although delayed hepatobiliary imaging is commonly used to differentiate between intrahepatic (IH) and extrahepatic (EH) obstruction in the newborn; there is room to clarify the use of delayed imaging in the adult population. A retrospective review was performed of adult patients demonstrating a complete obstructive pattern on initial Tc-99m mebrofenin hepatobiliary imaging. Delayed imaging was divided into early delayed (ED) (<10 h) and late delayed (LD) (≥10 h) imaging. Two physicians qualified the presence of intestinal radiotracer (negative, low to high) on delayed images. Determination of EH or IH pathology was obtained from chart review. A total of 24 patients demonstrated an obstructive pattern using delayed Tc-99m mebrofenin hepatobiliary imaging, with delayed imaging ranging from 4 to 30 h. EH pathologies (choledocholithiasis, stricture, other) represented 63% of cases (n = 15), IH pathologies (cirrhosis, hepatitis, other) represented 33% cases (n = 8) and 1 case was indeterminate. 67% of EH cases showed intestinal activity on delayed imaging (67% on ED and 67% on LD imaging), whereas 63% of IH cases showed intestinal activity on delayed imaging (67% on ED imaging and 60% on LD imaging). The presence of intestinal activity on the both the early and delayed images did not differentiate between the IH and EH pathology groups. Subdividing the groups into ED imaging and LD imaging was also not predictive of determining location of obstructive pattern on the initial 1 h of imaging. This data suggests that delayed hepatobiliary scintigraphy has little or no role in determining the cause of obstructive pathology.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.136692hepatobiliary obstructionhepatobiliary scantc-99m mebrofenin
spellingShingle Robert Matthews
Mera Goodman
Pryanka Relan
Elham Safaie
Dinko Franceschi
Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed Imaging
World Journal of Nuclear Medicine
hepatobiliary obstruction
hepatobiliary scan
tc-99m mebrofenin
title Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed Imaging
title_full Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed Imaging
title_fullStr Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed Imaging
title_full_unstemmed Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed Imaging
title_short Tc-99m Mebrofenin Hepatobiliary Scan in Obstructive Hepatobiliary Disease: Determining Causes with Early and Late Delayed Imaging
title_sort tc 99m mebrofenin hepatobiliary scan in obstructive hepatobiliary disease determining causes with early and late delayed imaging
topic hepatobiliary obstruction
hepatobiliary scan
tc-99m mebrofenin
url http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.136692
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