Hepatobiliary Scintigraphy for the Diagnosis of Acute Cholecystitis

Linda Giering, PhD*

*Medical Writer, Matawan, New Jersey

Address correspondence to: Linda Giering, PhD. Email: lindagiering@gmail.com.

Disclosure statement: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.



Acute cholecystitis is one of the most common reasons for hospital admission of patients with acute abdominal pain. Approximately 90% to 95% of cases of acute calculous cholecystitis are related to gallstones, and 5% to 10% of cases are due to acute acalculous disease. Hepatobiliary scintigraphy with iminodiacetic acid derivatives is an important adjunct in the evaluation of abdominal pain and the diagnosis of acute cholecystitis. The proper use of hepatobiliary scintigraphy requires a good understanding of the physiology of the hepatobiliary system, the metabolism of hepatobiliary radiopharmaceuticals, the sensitivity, specificity, and radiation dosimetry of currently used radiopharmaceuticals, and the accuracy and risk of alternative diagnostic imaging studies.

The absence of gallbladder filling identifies the cystic duct obstruction and defines the diagnosis of acute cholecystitis on hepatobiliary scintigraphy. Careful technique and patient preparation are important to a successful study and accurate diagnosis. The functional information available with nuclear imaging often cannot be obtained from anatomic imaging and can be used to make more accurate and confident diagnoses. Radiopharmaceuticals for hepatobiliary imaging have been available since the 1980s and they are used today for a variety of indications, but this review will focus only on the role of hepatobiliary scintigraphy for diagnosing acute cholecystitis.    

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