Evaluation of hepatocellular function by way of receptor-mediated uptake of a technetium-99m-labeled asialoglycoprotein analog.
We have developed a quantitative functional imaging study of the liver using a radiolabeled asialoglycoprotein analog, Tc-galactosyl-neoglycoalbumin. Heart and liver time-activity data can be transformed by automated kinetic analysis into asialoglycoprotein hepatocyte receptor concentration. Twenty-eight healthy controls, 46 patients with noncholestatic chronic liver injury and 11 patients with primary biliary cirrhosis were studied. Liver function was also assessed by Pugh modified-Child-Turcotte criteria, 14C-aminopyrine breath test and indocyanine green clearance (24 patients).


RESULTS
(a) In normal controls with a Child-Turcotte criteria score of 5, receptor concentration ranged from 0.63 to 1.19 mumol/L, with a mean 0.83 +/- 2 S.D. 0.06 mumol/L, which was significantly higher (p < 0.001) than that of the patient group (mean receptor concentration = 0.44 +/- 2 S.D. 0.04 mumol/L). In cirrhotic patients with Child-Turcotte criteria score of 5, the mean receptor concentration was 0.60 +/- 2 S.D. 0.07 mumol/L, which was significantly lower than controls (p < 0.01). In end-stage cirrhosis (Child-Turcotte criteria score 11 to 15), a group in which patients died or required orthotopic liver transplantation within 1 yr, the mean receptor concentration was 0.35 +/- 2 S.D. to 0.07 mumol/L. The sensitivity and specificity for receptor concentration in relation to liver disease, with values above 0.65 mumol/L being normal, were 0.96 and 0.88, respectively. Receptor concentration correlated well with Child-Turcotte criteria score (r = 0.78, p = < 0.001), with aminopyrine breath test (r = 0.75, p = < 0.001) and with indocyanine green clearance (r = 0.88, p = < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Pimstone
N R
NR
Department of Internal Medicine, University of California--Davis Medical Center, Sacramento 95817.
Stadalnik
R C
RC
Vera
D R
DR
Hutak
D P
DP
Trudeau
W L
WL
D000418:Albumins / Q000493:pharmacokinetics; D000632:Aminopyrine; D037263:Asialoglycoprotein Receptor; D001944:Breath Tests; D002250:Carbon Radioisotopes; D002908:Chronic Disease; D006801:Humans; D007208:Indocyanine Green; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D008105:Liver Cirrhosis, Biliary / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D011956:Receptors, Cell Surface / Q000378:metabolism*; D012680:Sensitivity and Specificity
D000418:Albumins; D037263:Asialoglycoprotein Receptor; D002250:Carbon Radioisotopes; D015609:Organotechnetium Compounds; D011956:Receptors, Cell Surface; C036586:technetium Tc 99m neogalactoalbumin; D000632:Aminopyrine; D007208:Indocyanine Green