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    Evaluation of hepatic hemangioma with technetium-99m RBC scintigraphy: A review of 74 cases with liver masses
    (2000) Yilmaz M.; Derebek E.; Dicle O.; Degirmenci B.; Sayit E.; Capa G.; Bekis R.
    Hepatic cavernous hemangioma is the most common benign tumor of the liver. We report the results of technetium-99m red blood cell (Tc-99m RBC) scan in patients with suspected hemangioma following ultrasonography (US) and/or computed tomography (CT). Of 74 patients with 117 liver masses, 55 had a provisional diagnosis of hemangioma, while the remaining 19 patients were negative for hemangioma. According to the final diagnosis, based on clinical follow-up, control US, biopsy and laparotomy, all patients with positive scintigraphy were eventually confirmed to have hemangiomas. In the scintigraphy negative group, there were 14 true negatives (7 metastases, 2 hepatocellular Ca, 1 cholangiocarcinoma, 1 biliary adenofibroma with malignant epithelial transformation, 1 abscess, 1 hydatid cyst 1 chronic active hepatitis with cirrhotic changes), and five false negative cases in whom SPECT failed to detect hemangiomas due to small size and location adjacent to the major intrahepatic vessels. The sensitivity, specificity, positive and negative predictive values were 92%, 100%, 100% and 74% respectively. In addition, 36 patients had Tc-99m tin colloid (Tc-99m TC) scan. Twenty one patients showed cold defects corresponding to the lesions (?2.5 cm) and 15 had normal appearance of colloid images due to small and deeply located lesions. Tc-99m RBC scan is a relatively sensitive and a very specific imaging method for noninvasive diagnosis of hemangioma. Tc-99m TC scan makes little contribution in the differential diagnosis.