Detection of acalculous gallbladder disease using Tc99m EHIDA imaging and cholecystokinin

The use of Tc99m ethyl hepatic iminodiacetic acid (EHIDA) imaging with cholecystokinin (CCK) in a prospective study of 115 patients with right upper quadrant biliary-type pain is described. All patients had normal US, oral cholecystography and/or endoscopy investigations. A 2-min infusion of CCK was administered at peak gallbladder uptake of EHIDA. A gallbladder ejection fraction (CBEF) was used to quantify the gallbladder response to CCK. A total of 79 of 115 patients (69%) had an abnormal GBEF (≤35%). Of 43 patients who underwent cholecystectomy 42 (97%) had abnormal surgical/histological findings and/or complete long-term relief of symptoms. It was concluded that Tc99m EHIDA imaging, with a 2-min infusion of CCK and a measured GBEF ≤35%, is highly predictive of acalculous gallbladder disease and a favourable outcome following cholecystectomy. (orig.)