Tc-99m RBC SPECT in hepatic cavernous hemangioma

Hepatic cavernous hemangioma (HCH) is the most common benign hepatic tumor which is detected incidentally during ultrasonography (US) done at health check-up and computed tomography (CT) done for evaluation of metastasis. The aim of the study is to evaluate retrospectively the accuracy of the modality in the diagnosis of HCH at our institution. 229 patients underwent Tc-99m RBC liver SPECT from Nov 16, 1994 to Sep 24, 2001. There were 127 males and 103 females. Their ages ranges from 82 to 17 years with a mean age of 45.8 years. Twenty millicuries of Tc-99m RBCs autologously labeled were injected. SPECT was done in 2-3 hours after the tracer administration and several hours delayed scan was also obtained in some patients. SPECT was performed with low energy high resolution collimators and triple-head gamma camera (MultiSPECT, Siemens medical systems, Inc., Hoffman Estate, III. USA). SPECT was evaluated visually and results were compared with US, CT, MRI, and clinical follow-up. Of the 156 patients a total of 210 hemangiomas were found in RBC liver SPECT. With regard to the distribution of the lesions, 113 cases revealed single; 43 cases depicted multiple HCHs, with 164 in the right lobe and 46 in the left lobe. The size of lesions ranges from 0.9 to 10 cm. Regarding the size of the lesions on radiographic image, 11 were less than 1cm, 144 were 1 to 4 cm, and the others were more than 4 cm in diameter. RBC liver SPECT is none-invasive and very useful method in the diagnosis of hepatic hemangioma in patients with sonographic and computed tomographic suspicion, if the size is more than 1 cm in diameter. The method is used often for confirmation of HCH in our institution