Evaluation of focal defects on technetium-99m sulfur colloid scans with new hepatobiliary agents

In 3600 patients evaluated with technetium-99m sulfur colloid for metastatic liver disease, 40 had equivocal scans due to a solitary defect in the inferior margin of the right lobe. In these patients, the authors differentiated the gallbladder fossa from a metastatic focus using one of two new hepatobiliary agents: technetium-99m labeled pyridoxylideneglutamate and paraisopropylacetanilido iminodiacetic acid. The need for laparoscopic biopsy was obviated in a majority (78%) of the patients by identifying the gallbladder fossa