Differentialdiagnosis of livertumors

This paper illustrates the importance of utilizing radionuclide techniques to characterize in vivo benign liver masses. Examining the tumor's physiologic function cholescintigraphy offers a highly specific pattern for identifying focal nodular hyperplasia (FHN): 1st hypervascularisation demonstrated in the perfusion phase by positive contrasted imaging, 2nd hepatocellular uptake (no contrast to normal liver tissue in the parenchymal phase) an 3rd impaired transport of the bilirubin like tracer documented as trapping in later images (> 90 min p.i.). An hemangioma is diagnosed with high probability in case of a positive bloodpoolscintigraphy. But falsepositive results have been reported. Therefore, a second unrelated examination, e.g. ultrasound, magnetic resonance imaging or dynamic computerized tomography is necessary to establish this diagnose in a sufficient certainity. If complications due to tumor growth are not expected, both, FNH and hemangioma needs no futher therapy. All other tumor entities have to be classified by cytologic or histologic examinations and are objective of resection if possible. Radiologic techniques are indicated to establish resectability or tumor spread. (orig.)