Validity of selected isotope imaging procedures (brain, skeletal and hepatobiliary diagnosis)

In a retrospective study we tested several scintigraphic investigations for a total of 2,014 patients. As reference we used the results of biopsy, autopsy or the epicritic final diagnosis before emission, summing up all clinical signs as well as the results of additional alternative methods and other imaging methods. Criteria of validity (sensitivity, specificity, diagnostic accuracy) are used in a consistent manner. Brain perfusion scintigraphy detected acute cerebral perfusion disorders with a sensitivity of 0.87, differentiating for reversible and irreversible lesions. Carotid angiography had the same diagnostic validity. Because there is no loss of brain substance, the validity of CT and static brain scintigraph was lower. Skeletal scintigraphy was highly sensitive for the detection of primary and secondary bone tumours as well as for the detection of inflammations and occult fractures. RHS scintigraphy of the liver, presently used for tumour and metastasis diagnosis after sonography and CT, has a sensitivity of 0.79. It was more sensitive for detecting inflammatory RHS liver disease (sensitivity 0.95). Biliary scintigraphy was seen under the surgical aspect only for selected questions. It was sensitive for the detection of biliary cyst disorders and the elucidation of complaints after biliary tract sanitation (sensitivities 0.92 and 0.84) and for the detection of duodenogastric reflux (0.7), but was of limited diagnostic value for the differentiation of hepatocellular and obturation icterus with a sensitivity of 0.5. (author)