The role of single-photon emission computed tomography in the diagnosis of hepatic hemangiomas

Background. Hemangioma is the most common benign liver neoplasm. In most cases, it is an accidental finding when examining abdominal organs. As a rule, hemangiomas have their own pathognomonic pattern in each type of radiodiagnosis. Sometimes their diagnosis can be difficult. Single-photon emission computed tomography (SPECT) with labeled red blood cells is a fairly accurate, noninvasive, low-cost method for diagnosing this pathology. Objective. Evaluation of the effectiveness of the SPECT with labeled erythrocytes in the diagnosis of hepatic hemangiomas. Methods. The study involved 147 patients (mean age 58±13.9) who underwent SPECT study of the liver in the PET center of Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in the period from 2011 to 2019. Results. According to the SPECT results, foci of RP hyperfixation described as hemangiomas were determined in 35% of cases; all these patients were diagnosed with hepatic hemangioma in 100% of cases. In 65% of patients, foci of increased accumulation of radiopharmaceuticals (RP) were not identified. Of these, metastatic liver damage was revealed in 40%, and hepatic atypical cysts or abscesses - in 28%. In the remaining 32% of patients, no RP hyperfixation foci were detected during the SPECT study, and based on 6-month follow-up, according to computed tomography or magnetic resonance imaging, diagnosis of hepatic hemangioma was made. Of these, in 67% of cases, the hemangioma size was <10 mm, and in 27% of cases the formations were close to blood vessels. In 6% of cases, atypical forms of hemangiomas were detected. Depending on the size of the formations, sensitivity and specificity indicators were calculated. As a result, the lowest sensitivity and specificity were determined with respect to formations of size <10 mm. The highest values were determined for formations with a size of >20 mm. Conclusion. The SPECT shows high specificity in the detection of hepatic hemangiomas. However, sensitivity varies depending on the size of the formations and their localizations. With size of the formations <10 mm or localization near blood vessels, the sensitivity of the method decreases.

single-photon emission computed tomography, hepatic hemangioma, radiodiagnosis, nuclear medicine