Clinical evaluation of 99mTc-n-pyridoxyl-5-methyltryptophan hepatobiliary scintigraphy in hepatocellular carcinoma.

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We have assessed the diagnostic value of 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatobiliary scintigraphy in 28 patients with hepatocellular carcinoma (HCC) who had obvious filling defects on 99mTc-phytate liver scintigram. Uptake of 99mTc-PMT in obvious defects on 99mTc-phytate liver scintigram was observed in 16 out of 28 patients (57.1%). Most of HCC with 99mTc-PMT uptake were histologically well-differenciated. However, well-differenciated HCC did not always take up 99mTc-PMT. No correlation was observed between 99mTc-PMT uptake in the tumor and levels of serum alpha-fetoprotein. Patients with high alpha-fetoprotein level (>3000ng/ml) were only 9 patients (32.1%) in our study. By the combined results of 99mTc-PMT hepatobiliary scintigraphy and alpha-fetoprotein level (>3000ng/ml), diagnostic rate for HCC was markedly elevated up to 75%.Therefore, it is considered that 99mTc-PMT hepatobiliary scintigraphy is clinically useful for specific diagnosis of HCC. Furthermore, it provides the information for invasion of HCC into the bile duct.