The Diagnostic Application of Radiocolloid Liver Scintigraphy in Breast Carcinoma

The authors have reviewed their experiences in determining the presence of liver metastases in 103 patients by radiocolloid scanning. The sensitivity of liver scanning proved to be quite low if the presence of focal defects in the distribution of the tracer was chosen as the diagnostic criterion. The inclusion of less restrictive criteria such as liver enlargement or irregular distribution of the tracer, resulted in a higher sensitivity without lowering the predictive value of a negative scan. Using the latter diagnostic criterion, sensitivity, specificity and accuracy were in the range of 90%. Abnormal liver scans are common in patients classified as T3–T4 or N+ and their chances of being “true positive” are high. Conversely, abnormal scans are seldom found in patients classified as T1–T2 or N₀ and probabilities of “false positive” results are high.

Die Autoren analysierten ihre Erfahrungen mit der Bestimmung der Lebermetastasierung mit Radiokolloid-Scanning bei 103 Patienten. Die Sensitivität der Leberszintigraphie war relativ niedrig, wenn die fokalen Speicherungsdefekte innerhalb der Verteilung des Kolloids als einziges diagnostisches Kriterium gewählt wurden. Der Miteinbezug weniger restriktiver Kriterien wie Vergrößerung der Leber oder ungleichmäßige Tracerverteilung brachte eine höhere Sensitivität, ohne den prognostischen Wert eines negativen Scans herabzusetzen. Die Sensitivität, die Spezifität und die Genauigkeit lagen bei Anlegen dieser letzteren, weiter gefaßten diagnostischen Kriterien im 90%Bereich. Abnormale Leberscans waren häufig bei Patienten mit T3–T4 oder N+; bei ihnen war die Wahrscheinlichkeit „richtig positiv” zu sein, hoch. Dagegen waren abnormale Scans bei den als T1–T2 oder N₀ klassifizierten Patienten selten und somit in dieser Gruppe die Wahrscheinlichkeit „falsch positiver“ Resultate hoch.

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