title: [Clinical utility of receptor imaging in the assessment of liver function].
abstract: 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.
authors.affiliation: Department of Internal Medicine, Kobe City General Hospital.
authors.forename: M
authors.initials: M
authors.lastname: Kudo
authors.forename: K
authors.initials: K
authors.lastname: Ikekubo
authors.forename: A
authors.initials: A
authors.lastname: Todo
authors.forename: J
authors.initials: J
authors.lastname: Mimura
authors.forename: Y
authors.initials: Y
authors.lastname: Okabe
authors.forename: H
authors.initials: H
authors.lastname: Kashida
authors.forename: M
authors.initials: M
authors.lastname: Hirasa
authors.forename: Y
authors.initials: Y
authors.lastname: Ibuki
authors.forename: S
authors.initials: S
authors.lastname: Tomita
authors.forename: H
authors.initials: H
authors.lastname: Komori
mesh_terms: 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
chemical_list: 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