Comparison of liver enzymes and liver scan in the detection of hepatic metastases

We studied 100 patients with autopsy proven metastatic liver disease and another 100 patients with no evidence of metastases to compare the sensitivity, specificity and predictive value of the liver scan, alkaline phosphatase, lactate dehydrogenase (LDH) and glutamic oxaloacetate transaminase in the detection of hepatic metastases. We found LDH to be a fairly sensitive and specific indicator of metastatic liver disease. The patients with metastases were subdivided into four groups depending on whether the scan and enzymes were positive or negative. Study of these groups revealed that the scan was of little additional value to what was already obtained by clinical examination and enzyme measurements.