Tc-99m HIDA hepatobiliary agent in the diagnosis of pulmonary metastasis from hepatocellular carcinoma.

Twelve patients with hepatocellular carcinoma and multiple metastatic pulmonary nodules were studied with Tc-99m HIDA imaging. Lung scanning was performed 1, 2, 3, 4, and 5 hours after administration of 6 mCi of Tc-99m HIDA with a preset count format of 400 K. In two patients, pulmonary uptake was clearly seen at 1 hour; in the other two patients, uptake could not be detected until 3 hours later. The overall detection rate of 33% suggests that Tc-99m HIDA has limited usefulness as a routine diagnostic tool in the detection of hepatoma metastases. The uptake may include both specific and nonspecific mechanisms.