Single-photon emission computed tomography (SPECT) for assessment of hepatic lesions.

Single-photon emission computed tomography (SPECT) and conventional scintigraphy were compared in 130 patients examined to assess hepatic involvement in malignant disease. Transmission computed tomography (TCT) served as the reference method against which SPECT and conventional scintigraphy were compared. The sensitivity of SPECT was calculated for lesions grouped according to diameter as well as location. The Bayesian theorem was used to assess the reliability of both SPECT and conventional scintigraphy. SPECT identified only 52% of lesions with a diameter of 1.5-2.0 cm. It was also shown that the sensitivity of SPECT was lowest for small lesions in the middle third of the liver. A comparison of the final diagnosis demonstrated that SPECT had greater sensitivity, specificity, and accuracy than conventional scans, and is superior at low disease prevalence. At high disease prevalence, SPECT has a lower rate of false negatives. SPECT appears to be the superior imaging modality for evaluation of the liver in malignant disease.