The Liver Scan in Metastatic Disease

One hundred eleven patients with a primary extrahepatic malignancy and documentation of the presence or absence of hepatic metastases were selected for study. Fifteen of 16 with abnormal liver function test results and hepatomegaly secondary to metastatic disease had abnormal liver scans, but in this group of patients the clinical diagnosis of metastatic disease was obvious, and the scan added little. Ten patients had documented metastatic disease with normal liver function test results and normal livers on examination. The scan in this group was abnormal in only one case, a rate exceeded by the rate of falsely abnormal scans for the procedure. In 62 patients with the documented absence of hepatic metastases and normal liver function test and physical examination results, the scan was either abnormal or equivocal in seven patients. This study suggests that the liver scan does not offer significant additional information in the detection of hepatic metastases and its routine use in this group of patients is not warranted.