Scintigraphic diagnosis of cirrhosis: a receiver operator characteristic analysis of the common interpretative criteria.

Receiver operator characteristic (ROC) techniques were used to determine relative importance of heterogeneity, bone marrow uptake, hepatomegaly, splenomegaly, and focal lesions in the scintigraphic diagnosis of cirrhosis, as well as to determine whether each of the criteria should be used as an identifier (high sensitivity) or as a discriminator (high specificity). Heterogeneity, splenomegaly, and bone marrow uptake were found to be good identifiers of hepatic disease. However, heterogeneity was found to be a poor discriminator for cirrhosis, splenomegaly showed some value as a discriminator, and bone marrow uptake was found to be a reliable discriminator for alcoholic liver disease. The presence of focal lesions was a good discriminator for metastatic disease, and was not specific for cirrhosis. Hepatomegaly also was not specific for cirrhosis. This method of analysis provides a relatively simple method for assembling a hierarchical guide to diagnostic criteria for the interpreting physician.