Nuclear Medicine of Hepatobiliary System (SPECT and PET)

Nuclear medicine techniques allow the functional evaluation of the liver and the biliary system. Biliary scintigraphy using technetiated iminodiacetic acid (IDA) derivatives explores the biliary excretion from the uptake at the vascular pole of the hepatocyte to the bile excretion in the intestinal lumen. Positron Emission Tomography (PET), either in a PET/CT scanner or in a PET/MR tomograph, relies on 18F-fluoro-deoxy-glucose (18F-FDG) or labelled choline to detect more aggressive and less aggressive hepato-cellular carcinomas (HCC) respectively. Neuroendocrine tumors arising in the gastroenteric tract or in the pancreas (NET-GEP) are best evaluated by DOTA compounds (DOTATOC, DOTANOC, and DOTANOE), labelled with 68Ga. They share a high affinity for the SSR-2, which is widely expressed in NET-GEP and represents an excellent opportunity for the evaluation of the primary tumor and the metastatic disease, including the liver.