Oral mTc-Pertechnetate: An Aid in the Differentiation of Epigastric Lesions

Occasionally, abnormalities in the upper portion of the abdomen may be suspected by the appearance or configuration of the liver, spleen, or kidneys during radionuclide imaging. For example, during liver and spleen imaging with 99mTc-sulfur colloid, the spleen may appear separated from the liver or assume an unusual flattened configuration against the abdominal wall. The presence of an epigastric mass may be suspected. Since the stomach occupies that space between the left lobe of the liver and the spleen, the simple ingestion of 99mTc-pertechnetate following the routine liver and spleen images may resolve this problem readily by visualizing that space. This technique will probably be of greatest value in the localization of subdiaphragmatic abscesses. There are several potential spaces in the abdomen that are subhepatic and subsplenic in location that are virtually impossible to evaluate with routine imaging techniques. Oral 99mTcpertechnetate will demonstrate these abnormal spaces.