Gallium-67-citrate scanning in primary cancer of the liver: diagnostic value in the presence of cirrhosis and relation to alpha-fetoprotein.

Gallium-67-citrate and 99mTc-sulfur colloid scans were performed in 38 South African blacks with primary hepatocellular cancer. Selective uptake of the radinuclide by the tumor occurred in 27 patients (70%). In 12 out of 18 patients with associated cirrhosis, 67Ga was concentrated in the defect or defects visible on the 99mTc-sulfur colloid scan, but in the remaining 6 cases (33%), the 2 scans were identical and the defects may have been attributed wrongly to cirrhosis. Alpha-fetoprotein (AFP) was detected by immunodiffusion in the serum of 26 patients. Twenty-one of these showed selective uptake of 67Ga by the tumor as compared with 6 out of 12 patients in whom this protein could not be detected. We were therefore unable to confirm a previous finding of a greater uptake of the of the radionuclide in AFP-negative primary liver cancer.