Fulminant hepatic failure monitored by technetium-99m-DTPA-galactosyl-human serum albumin scintigraphy.

We describe a 43-yr-old woman with fulminant hepatic failure whose progress was monitored scintigraphically using 99m-Tc-galactosyl-human serum albumin (99mTc-GSA). On admission, the liver was atrophic and the heart was delineated distinctly by scintigraphy with 99m-Tc-GSA. The receptor index, calculated by dividing the radioactivity of the liver region of interest by the radioactivity of the liver plus heart regions of interest at 15 min post-tracer injection, was very low. As the patient's condition improved, the right lobe of the liver enlarged while the left lobe became atrophic; after 4 mo, the left lobe almost completely disappeared. Delineation of the heart gradually became less distinct, and the receptor index slowly increased. Hepatic receptor imaging with 99m-Tc-GSA can define both the hepatic functional reserve and morphological changes of the liver, so it is useful for the diagnosis and follow-up study of fulminant hepatic failure.