126 Space Occupying Masses in the Liver

Clinical Presentation

A 71-year-old man who has pancreatic cancer presents with right upper quadrant pain. The patient is given narcotic analgesia before biliary scintigraphy is started (Fig. 126.1).

Fig. 126.1

Technique

• The patient should take nothing by mouth between less than 24 hours and more than 4 hours before the test.

• Immediately following the injection of 1.5 mCi of ^99mTc-DISIDA, the patient is placed in a supine position beneath the gamma camera.

• Continuous images acquired in a 64 × 64 matrix are divided into 1-minute frames.

• Images are obtained in the left anterior oblique projection with a slant-hole collimator to better separate the small bowel from the liver. Straight anterior views may be obtained with a high-resolution, parallel-hole collimator if a slant-hole collimator is not available.

• Delayed static images may be acquired as necessary.