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Use of Liver Scans and Biochemical Liver Tests

Margaret A. Tempero, MD; Richard J. Petersen, MD; Rowen K. Zetterman, MD; Henry M. Lemon, MD; Jud Gurney, MD

JAMA. 1982;248(11):1329-1332.

Abstract
The records of 94 patients with a known diagnosis of extrahepatic cancer having liver scan, biochemical liver tests (alkaline phosphatase, SGOT, lactic dehydrogenase, and bilirubin levels, and subsequent liver biopsy within a six-week period were reviewed. The sensitivity, specificity, and accuracy of the scan and biochemical tests in the detection of metastatic liver disease were calculated. The most sensitive single examination was the group of biochemical liver tests. Liver scans performed in the presence of normal biochemical test results were insensitive when compared with the liver scan alone or the liver scan in the presence of abnormal biochemical test results. The specificity and accuracy of all tests and test combinations were statistically equivalent. Screening for hepatic metastases in patients with cancer is best accomplished with the more sensitive and less expensive group of biochemical liver tests, reserving the liver scan for those patients with abnormal biochemical test results.

(JAMA 1982;248:1329-1332)

Author Affiliations
From the Sections of Oncology (Drs Tempero and Lemon) and Gastroenterology (Dr Zetterman), Department of Internal Medicine, and the Department of Radiology (Dr Gurney), University of Nebraska Medical Center, and the Department of Radiology, Bishop Clarkson Memorial Hospital (Dr Petersen), Omaha.

Footnotes
Reprint requests to Section of Oncology, Department of Internal Medicine, University of Nebraska Medical Center, 42nd Street and Dewey Avenue, Omaha, NE 68105 (Dr Tempero).

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