[Clinical utility of receptor imaging in the assessment of liver function].
Technetium-99m diethylene triamine pentaacetic acid-galactosyl human serum albumin (TcGSA) is a newly developed receptor-binding radiopharmaceutical, specific for the asialoglycoprotein receptor, which resides exclusively on the plasma membrane of hepatocytes. Clinical utility of TcGSA was evaluated in 3 control subjects with normal livers and in 54 patients with various liver diseases. The parameter, Receptor Index, was derived from liver and heart time-activity data and is the ratio of radioactivity of the liver over the radioactivity of the liver plus heart at 15 min after the intravenous injection of 3 mg of TcGSA. Receptor concentration ([R]o) was obtained by kinetic analysis of liver and heart time-activity data using pharmacokinetic nonlinear modeling. Values for the Receptor Index and [R]o was statistically different in the control subjects and in patients with mild, moderate, and severe liver diseases. Good correlations were obtained between the Receptor Index, [R]o and conventional liver function tests, such as Child-Turcotte criteria score, prothrombin time, and indocyanine green test. Receptor Index and [R]o were properly estimated even in patients with obstructive jaundice or remarkable portocaval shunt. These data suggest that the receptor imaging as well as its parameters, Receptor Index and [R]o, is a potentially practical and reliable diagnostic method for estimating the functioning hepatocyte mass and for assessing liver function.
Kudo
M
M
Department of Internal Medicine, Kobe City General Hospital.
Ikekubo
K
K
Todo
A
A
Mimura
J
J
Okabe
Y
Y
Kashida
H
H
Hirasa
M
M
Ibuki
Y
Y
Tomita
S
S
Komori
H
H
D000328:Adult; D000368:Aged; D037263:Asialoglycoprotein Receptor; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D011869:Radioligand Assay; D011877:Radionuclide Imaging; D011971:Receptors, Immunologic / Q000032:analysis*; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate
D037263:Asialoglycoprotein Receptor; D011971:Receptors, Immunologic; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate