Skip to main content

Hepatobiliary Scintigraphy

  • Chapter
Pediatric Nuclear Medicine

Abstract

Relatively noninvasive methods for the evaluation of the biliary system (such as ultrasonography, computed tomography, oral cholangiography, and intravenous cholecystography) provide excellent anatomic information. Hepatobiliary scintigraphy adds information on regional hepatic function, biliary flow, and drainage. The specific indications for hepatobiliary scintigraphy in children include the following: differentiation between biliary atresia and hepatitis in jaundiced newborns; evaluation of older children with right upper quandrant pain; postoperative evaluation of patients after the Kasai procedure and other abdominal interventions; and evaluation of right upper quadrant masses (Table 9-1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anghileri LJ. Preparation of bilirubin labeled with I-131. Int J Appl Radiat Isot 1963; 14: 630–3.

    Article  PubMed  CAS  Google Scholar 

  2. Ansari AN, Atkins HL, Lambrecht RM. I-123 indocyanine green (I-123 ICG) as an agent for dynamic studies of the hepatobiliary system. In: Dynamic studies with radioisotopes in medicine I. Vienna: IAEA, 1975.

    Google Scholar 

  3. Awasthi YC, Dao DD, Saneto RP. Interrelationships between anionic and cationic forms of glutathione S-transferases of human liver. Biochem J 1980; 191: 1–10.

    PubMed  CAS  Google Scholar 

  4. Baker RJ, Bellen JC, Ronai PM. Tc-99m pyridoxylideneglutamate: a new rapid cholescintigraphic agent (abstract). J Nucl Med 1974; 15: 476.

    Google Scholar 

  5. Bastomsky CH, Horton PW, Shimmins J. Gamma camera study of the hepatobiliary excretion of I131-thyroxine glucuronide and I-131-rose bengal in the rat. J Nucl Med 1973; 14: 34–39.

    PubMed  CAS  Google Scholar 

  6. Bobba VVR, Krishnamurthy GT, Kingston E, Brown PH, Eklem M, Turner FE. Comparison of biokinetics and biliary imaging parameters of four Tc-99m iminodiacetic acid derivatives in normal subjects. Clin Nucl Med 1983; 8: 70–75.

    Article  PubMed  CAS  Google Scholar 

  7. Brent RL, Geppert LJ. The use of radioactive rose bengal in the evaluation of infantile jaundice. J Dis Child 1959; 98: 720–30.

    CAS  Google Scholar 

  8. Burns D, Marzilli L, Sowa D, Baum D, Wagner HN Jr. Relationship between molecular structure and biliary excretion of Tc-99m HIDA and HIDA analogs (abstract). J Nucl Med 1977; 18: 624.

    Google Scholar 

  9. Burns HD, Sowa DT, Marzilli LG. Improved synthesis of N-(2,6-dimethyl-phenyl-carbamoylmethyl) iminodiacetic acid and analogs. J Pharm Sci 1978; 67: 1434–6.

    Article  PubMed  CAS  Google Scholar 

  10. Burns HD, Sowa DT, Worley P, Vaum R, Marzilli LG. Electrophoretic determination of charge on carrier-free 99mTc-labeled complexes. J Pharm Sci 1981; 70: 436–9.

    Article  PubMed  CAS  Google Scholar 

  11. Butterman G, Wolf I, Pabst HW. Quantitative analysis of hepatograms using a gamma camera and labeled contrast media. In: Dynamic studies with radioisotopes in medicine I. Vienna: IAEA, 1975.

    Google Scholar 

  12. Callery P, Faith WC. Loberg MD, Fields AT, Harvey EB, Cooper MD. Tissue distribution of Tc-99m and C-14 labeled N-(2,6-dimethylphenyl-carbamoylmethyl) iminodiacetic acid. J Med Chem 1976; 19: 962–4.

    Article  PubMed  CAS  Google Scholar 

  13. Caroli J. Diseases of intrahepatic bile ducts. Isr J Med Sci 1968; 4: 21–35.

    PubMed  CAS  Google Scholar 

  14. Caroli J, Soupault R, Kossakowski J, Plocker L, Paradowska M. La dilatation polykystique congenitale des voies biliaires intrahepatiques. Essai de classification. Semin Hop Paris 1958; 34: 488–95.

    CAS  Google Scholar 

  15. Chaberek S, Martell AE. Stability of metal chelates I. Iminodiacetic and iminodipropionic acids. J Am Chem Soc 1952; 74: 5052–6.

    Article  CAS  Google Scholar 

  16. Chervu LR, Nunn AD, Loberg MD. Radiophar maceuticals for hepatobiliary imaging. Semin Nucl Med 1982; 12: 5–17.

    Article  PubMed  CAS  Google Scholar 

  17. Chiotellis E, Varvarigou A. Tc-99m labelled N-substituted carbamoyl iminodiacetates: relationship between structure and biodistribution. Int J Nucl Med Biol 1980; 7: 1–7.

    Article  PubMed  CAS  Google Scholar 

  18. Christy B, King G, Smoak WM. Preparation of iodine-123 labeled rose-bengal and its distribution in animals (abstract). J Nucl Med 1974; 15: 484.

    Google Scholar 

  19. Collier BD, Treves S, Davis MA, Heyman S, Sub ramanian G, McAfee JG. Simultaneous Tc-99m p-butyl-IDA and I-131 rose-bengal scintigraphy in neonatal jaundice. Radiology 1980; 134: 719–22.

    PubMed  CAS  Google Scholar 

  20. Costello CE, Brodack JW, Jones AG, Davison A, Johnson DL, Kasina S, Fritzberg AR. The investigation of radiopharmaceutical components by fast atom bombardment mass spectrometry: the identification of Tc-HIDA and the epimers of Tc-CO2DADS. J Nucl Med 1983; 24: 353–5.

    PubMed  CAS  Google Scholar 

  21. Crystal RF, Fink RL. Acute acalculous cholecystitis in childhood. Clin Pediatr 1971; 10: 423–6.

    Article  CAS  Google Scholar 

  22. Czerniak P, Boruchowsky S, Yarshova A, et al. Use of radioactive toludine blue for cholescintigraphy. In: Medical radioisotope scintigraphy II. Vienna: IAEA, 1972.

    Google Scholar 

  23. Dickinson SJ, Corley G, Santulli TV. Acute cholecystitis as a sequel of scarlet fever. Am J Dis Child 1971; 121: 331–3.

    PubMed  CAS  Google Scholar 

  24. Eckelman W, Richards P. Instant 99mTc-DTPA. J Nucl Med 1970; 11: 761.

    PubMed  CAS  Google Scholar 

  25. Franken EA, Smith WL, Smith JA, Fitzgerald JR.Percutaneous cholangiography in infants. AJR 1978; 130: 1057–8.

    Article  PubMed  Google Scholar 

  26. Gellis SS. Biliary atresia. Pediatrics 1975; 55: 8–9.

    PubMed  CAS  Google Scholar 

  27. Gerhold JP, Klingensmith WC, Kuni CC, Lilly JR, Silverman A, Fritzberg AR, Nixt TL. Diagnosis of biliary atresia with radionuclide hepatobiliary imaging. Radiology 1983; 146: 499–504.

    PubMed  CAS  Google Scholar 

  28. Goris ML. I-123-iodo-bromosulphtalein as a liver and biliary scanning agent. J Nucl Med 1973; 14: 820–5.

    PubMed  CAS  Google Scholar 

  29. Green A. Rosenberg N, Sheahan M. Multicenter Tc -99m disofenin (diisopropylphenyl-carbamoylmethyl iminodiacetic acid): a new hepatobiliary agent for imaging jaundiced and unjaundiced patients (abstract). J Nucl Med 1980; 21: 18.

    Google Scholar 

  30. Green HL, Helinek GL, Moran R, O’Neill J. A diagnostic approach to prolonged obstructive jaundice by 24-hour collection of duodenal fluid. J Pediatr 1979; 95: 415–4.

    Article  Google Scholar 

  31. Hallaba E, Abdullah E. Preparation of diiolo-I-131 Fluorescein and tetraiodo-I-131 phenolphthalein for diagnostic purposes. Int J Appl Radiat Isot 1966; 17: 424–6.

    Article  Google Scholar 

  32. Harvey E, Loberg MD, Cooper M. Tc-99m-HIDA; a new radiopharmaceutical for hepatobiliary imaging (abstract). J Nucl Med 1975; 16: 533.

    Google Scholar 

  33. Hashimoto T, Yura J. Percutaneous transhepatic cholangiography (PTC) in biliary atresia with special reference to the structure of the intrahepatic bile ducts. J Pediatr Surg 1981; 16: 22–25.

    Article  Google Scholar 

  34. Hays DM, Woolley MM, Snyder WH Jr, Reed GB, Gwinn JL, Landing BH. Diagnosis of biliary atresia: relative accuracy of percutaneous, liver biopsy, open liver biopsy, and operative choolangiography. J Pediatr 1967; 71: 598–607.

    Article  PubMed  CAS  Google Scholar 

  35. Hernandez M, Rosenthal L. A cross-over study comparing the kinetics of Tc-99m-labeled diisopropyl and para-butyl IDA analogs in patients. Clin Nucl Med 1980; 5: 159–65.

    Article  PubMed  CAS  Google Scholar 

  36. Hirsig J, Rickham PP, Early differential diagnosis between neonatal hepatitis and biliary atresia. J Pediatr Surg 1980; 15: 13–15.

    Article  PubMed  CAS  Google Scholar 

  37. Hitch DC, Shikes RH, Lilly JR. Determinants of survival after Kasai’s operation for biliary atresia using actuarial analysis. J Pediatr Surg 1979; 14: 310–4.

    Article  PubMed  CAS  Google Scholar 

  38. Kasai M, Watanabe I, Ohi R. Follow-up studies of long-term survivors after hepatic portoenterostomy for “noncorrectable” biliary atresia. J Pediatr Surg 1975; 10: 173–82.

    Article  PubMed  CAS  Google Scholar 

  39. Kim SH. Choledochal cyst: survey by the surgical section of the American Academy of Pediatrics. J Pediatr Surg. 1981; 16: 402–7.

    Article  PubMed  CAS  Google Scholar 

  40. Klingensmith WC, Fritzberg AR, Koep LJ. Comparison of Tc-99m diethyl-iminodiacetic acid and I-131 rose Bengal for hepatobiliary studies in liver transplant patients. J Nucl Med 1979; 20: 314–8.

    PubMed  Google Scholar 

  41. Klingensmith WC, Fritzberg AR, Spitzer VM, Koep LJ. Clinical comparison of 99mTc-diethyl-IDA and 99mTc-PIPIDA for evaluation of the hepatobiliary system. Radiology 1980; 134: 195–9.

    PubMed  Google Scholar 

  42. Klingensmith WC, Fritzberg AR, Spitzer VM, Kuni CC, Shanahan WSM. Clinical comparison of Tc 99m diisopropyl-IDA and diethyl-IDA Tc 99m for evaluation of the hepatobiliary system. Radiology 1981; 140: 791–5.

    PubMed  Google Scholar 

  43. Laperche Y, Graillot C, Arondal J, Berthelot P.Uptake of rifampicin by isolated rat liver cells. Interaction with sulfobromophthalein uptake and evidence for separate carriers. Biochem Pharmacol 1979; 28: 2065–9.

    Article  PubMed  CAS  Google Scholar 

  44. Loberg MD. Radiotracer distribution by active transport: the implication of non-linear kinetics. In: Colombetti LG, ed. Principles of Radiopharmacology. Boca Raton Fla: CRC Press, 1979.

    Google Scholar 

  45. Loberg MD, Cooper M, Harvey E, Callery P, Faith W. Development of new radiopharmaceuticals based on N-substitution of iminodiacetic acid. J Nucl Med 1976; 17: 633–8.

    PubMed  CAS  Google Scholar 

  46. Loberg MD, Nunn AD, Porter DW. Development of hepatobiliary imaging agents. In: Freeman LM, Weissmann HS, eds. Nuclear medicine annual. New York: Raven Press, 1981.

    Google Scholar 

  47. Majd M, Reba RC, Altman RP. Hepatobiliary scintigraphy with Tc-99m PIPIDA in the evaluaton of neonatal jaundice. Pediatrics 1981; 67: 140–5.

    PubMed  CAS  Google Scholar 

  48. Nunn AD. Structure-distribution relationships of radiopharmaceuticals. Correlation between the reversed-phase capacity factors for Tc-99m phenylcarbamoylmethyliminodiacetic acids and their renal elimination. J Chromatogr 1983; 255: 91–100.

    Article  PubMed  CAS  Google Scholar 

  49. Nunn AD, Loberg MD, Conley RA. A structure-distribution relationship approach leading to the development of Tc-99m mebroferin: an improved cholescintigraphic agent. J Nucl Med 1983; 24: 423–430.

    PubMed  CAS  Google Scholar 

  50. Odell GBN, Boitnott JK. Evaluation of jaundice. In: James AE, Wagner HN, Cook RE, eds. Pediatric nuclear medicine. Philadelphia: W.B. Saunders, 1974.

    Google Scholar 

  51. Porter DW, Loberg MD, Eacho PI, Weiner M. Comparison of hepatobiliary radiopharmaceuticals in an in-vitro model (abstract). J Nucl Med 1979; 20: 642.

    Google Scholar 

  52. Reyes H, Levi AJ, Gatmaitan Z, Arias IM. Studies of Y and Z, two hepatic cytoplasmic organic anion-binding proteins: effect of drugs, chemicals, hormones and cholestasis. J Clin Invest 1971; 50: 2242–52.

    Article  PubMed  CAS  Google Scholar 

  53. Schwenk M. Transport systems of isolated hepatocytes. Studies on the transport of biliary compounds. Arch Toxicol 1980; 44: 113–26.

    Article  PubMed  CAS  Google Scholar 

  54. Spenney JG, Tobin MM, Mihas AA, Gibson RG, Hirschowitz BI, Johnson BJ, Tauxe WN. Utilization of a radioiodinated bile salt for kinetic studies and hepatic scintigraphy. Studies in nonhuman mammals. Gastroenterology 1979; 76: 272–8.

    PubMed  CAS  Google Scholar 

  55. Taplin GV, Meredith OM, Kade H. The radioactive I-131 tagged rose bengal uptake excretion test for liver function using eternal gamma ray scintillation counting techniques. J Lab Clin Med 1955; 45: 665–78.

    PubMed  CAS  Google Scholar 

  56. Tubis M, Bland DW, Nordyke RA. The preparation and use of radioiodinated congo red in detecting amyloidosis. J Am Pharm Assoc Sci Ed 1960; 49: 422–5.

    Article  CAS  Google Scholar 

  57. Tubis M, Nordyke RA, Posnick E, Bland WH. Preparation and use of ‘31I labeled sulfobromophtalein in liver function testing. J Nucl Med 1961; 2: 282–8.

    PubMed  CAS  Google Scholar 

  58. Utz JA, Lull RJ, Anderson JH, Lambrecht RW, Brown JM, Henry W. Hepatoma visulaization with Tc-99m pyridoxylidene glutamate. J Nucl Med 1980; 21: 747–9.

    PubMed  CAS  Google Scholar 

  59. Van Rijk PP, DeGraff CN. I-131 asialo-l-acid-glycoprotein. A new radiopharmaceutical for dynamic liver function studies. In: Dynamic studies with radioisotopes in medicine I. Vienna: IAEA, 1975.

    Google Scholar 

  60. Vonk RJ, Danhof M, Coenraads T, Van Doorn ABD, Keulmans K, Scaf AHJ, Meijer DKF. Influence of bile salts on hepatic transport of dibromosulphthalein. Am J Physiol 1979; 237: 524–34

    Google Scholar 

  61. Walker CHM. Aetiology of cholelithiasis in childhood. Arch Dis Child 1957; 32: 293–7.

    Article  PubMed  CAS  Google Scholar 

  62. Wechsler RL. Van Thiel D. Fibropolycystic disease of the hepatobiliary system and kidneys. Am J Dig Dis 1976; 21: 1058–69.

    Article  PubMed  CAS  Google Scholar 

  63. Weissmann HS, Chun KH, Frank MS, Koenigsberg M, Milstein DM, Freeman LM. Demonstration of traumatic bile leakage with cholescintigraphy and ultrasonography. AJR 1979; 133: 843–7.

    Article  PubMed  CAS  Google Scholar 

  64. Weissmann HS, Frank M, Bernstein LM, Freeman LM. Rapid and accurate diagnosis of acute cholecystitis with Tc-99m HIDA cholescintigraphy. AJR 1979; 132: 523–8.

    Article  PubMed  CAS  Google Scholar 

  65. Weissmann HS, Rosenblatt R, Sugarman LA, Freeman LM. The role of nuclear imaging in evaluating the patient with cholestasis. Semin Ultrasound 1980; 1: 134–42.

    Google Scholar 

  66. Weissmann HS, Sugarman LA, Freeman LM. The clinical role of technetium-99m iminodiacetic acid cholescintigraphy. In: Freeman LM, Weissmann HS, eds. Nuclear medicine annual. New York: Raven Press, 1981.

    Google Scholar 

  67. Weissman HS, Badia J, Sugarman LA, Kluger L, Rosenblatt R, Freeman LM. Spectrum of cholescintigraphic patterns in acute cholecystitis. Radiology 1981; 138: 167–75.

    Google Scholar 

  68. Wistow BW, Subramanian G, Van Heertum RL, Henderson RW, Gagne GM, Hall RC, McAfee JG. An evaluation of 99mTc-labeled hepatobiliary agents. J Nucl Med 1977; 18: 455–61.

    PubMed  CAS  Google Scholar 

  69. Yokoyama A, Terauchi Y, Horiuchi K, Tanaka H, Odori T, Morita R, Mori T, Torizuka K. Technetium-99m kethoxal-bis(thiosemicarboxone), an uncharged complex with a tetravelant 99mTc state, and its excretion into the bile. J Nucl Med 1976; 17: 816–19.

    PubMed  CAS  Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 1985 Springer Science+Business Media New York

About this chapter

Cite this chapter

Treves, S.T., Jones, A. (1985). Hepatobiliary Scintigraphy. In: Pediatric Nuclear Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-1874-4_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-1874-4_9

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-1876-8

  • Online ISBN: 978-1-4757-1874-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics