99mTc-galactosyl serum albumin (GSA), a specific radiolabeled synthetic ligand for asialoglycoprotein receptors on hepatocytes, was used for functional liver imaging in 18 patients. Six patients had chronic hepatitis, and 12 had liver cirrhosis. Serial scintigraphic images were obtained for 60 minutes after intravenous administration of 1 mg of the ligand. High-quality images of the liver was obtained in all the patients. Dispersed accumulation in the liver in association with delayed clearance of the ligand from the heart was noted in cirrhotic patients. The activity of the entire liver (L) and that of the heart (H) were measured. The capacity of the liver in terms of elimination of the ligand was estimated by calculating [L/H+L] 15 and 30 minutes after the administration. [L/H+L] showed significant differences between patients with chronic hepatitis and those with liver cirrhosis, and also showed significant correlations with laboratory values such as indocyanine green clearance, prothrombin time, hepaplastin test, serum albumin level, and the Child-Turcotte classification score. 99mTc-GSA might be a useful radiopharmaceutical for obtaining hepatic functional images.