Clinical value of liver scans.

The contribution of technetium sulfacolloid liver scans on patient care was evaluated in 200 consecutive patients; 100 in a public (Grady) and 100 in a private (Emory University) hospital. The problem oriented record clearly described the effect of liver scan on: 1. assessment of the patient's problem(s) and 2. plans made for its diagnosis or management. For the diagnosis and treatment of 30 patients with intrinsic hepatobiliary diseases, the scan was useful in five but was misleading in four. Specific diagnosis was obtained by other methods which made the liver scan an unnecessary overutilization of a diagnostic procedure in the evaluation of patients with primary liver or biliary diseases. The scan was useful in 95 of 123 patients with extrahepatic malignancy. This was mostly due to chemotherapy protocols requiring the scans. Only 18% of positive scans had no other clinical evidence for hepatic malignancy. Definite diagnosis was not made in any of the 123 patients by liver scan. In 47 miscellaneous conditions the scan was useless in 37 (79%). In three of these the scan was misleading and impaired patient care.