Technetium-99m NGA functional hepatic imaging: preliminary clinical experience.
Technetium-99m galactosyl-neoglycoalbumin ( [Tc]NGA) is a radiolabeled ligand to hepatic binding protein, a receptor which resides at the plasma membrane of hepatocytes. This receptor-binding radiopharmaceutical and its kinetic model provide a noninvasive method for the assessment of liver function. Eighteen patients were studied: seven with hepatoma, eight with liver metastases, four with cirrhosis (two had concurrent hepatoma and one chronic active hepatitis), and one patient with acute fulminant non-A, non-B hepatitis. Technetium-99m NGA liver imaging provided anatomic information of diagnostic quality comparable to that obtained with other routine imaging modalities, including computed tomography, angiography, ultrasound, and [Tc]sulfur colloid scintigraphy. Kinetic modeling of dynamic [Tc]NGA data produced estimates of standardized hepatic blood flow, Q (hepatic blood flow divided by total blood volume), and hepatic binding protein concentration, [HBP]. Clinical correlation was by classical Child-Turcotte criteria (CTC). Significant rank correlation was obtained between [HBP] estimates and CTC scores (rs = -0.72, p = 0.001). This correlation supports the hypothesis that [HBP] is a measure of functional hepatocyte mass. The combination of decreased Q and markedly reduced [HBP] may have prognostic significance; all three patients with this combination died of hepatic failure within 6 wk of imaging.
D000328:Adult; D000368:Aged; D000418:Albumins / Q000378:metabolism; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D005260:Female; D006521:Hepatitis, Chronic / Q000000981:diagnostic imaging; D006801:Humans; D007700:Kinetics; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D013667:Technetium / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D000418:Albumins; D015609:Organotechnetium Compounds; C036586:technetium Tc 99m neogalactoalbumin; D013667:Technetium