Separate analysis of asialoglycoprotein receptors in the right and left hepatic lobes using Tc-GSA SPECT.
The asialoglycoprotein receptor (ASGPR) is abundantly expressed on the sinusoidal surfaces of hepatocytes. We aimed to clarify the clinical significance of the regional distribution of ASGPRs in the human liver, especially in chronic viral hepatitis. Eighteen volunteers, 34 patients with chronic hepatitis, and 33 patients with cirrhosis (11/Child-Pugh A, 11/Child-Pugh B, 11/Child-Pugh C) were studied using a newly developed, conventional technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin ((99m)Tc-GSA), single photon emission computed tomography (SPECT) method. Using Cantlie's line as a guide, ASGPR dynamics were analyzed separately in the right and left lobes, as well as in the whole liver, using novel indices (the liver uptake ratio [LUR] and the liver uptake density [LUD], which reflect the amount and density of ASGPRs in the liver, respectively). Mean LUR and LUD values for the whole liver and the right and left lobes decreased with increasing progression of chronic viral hepatitis. The LUR for the whole liver correlated well with parameters measuring the hepatic functional reserve and the platelet count. The right LUR correlated particularly well with conventional liver function tests, and comparison of the right LUD with histologic findings showed that it was a good indicator of periportal and/or bridging necrosis and fibrosis. In conclusion, our (99m)Tc-GSA SPECT method was clinically useful in evaluating regional hepatic function and the progression of chronic viral hepatitis using dynamic changes in ASGPRs.
Sugahara
Kazuhiko
K
Department of Internal Medicine and Molecular Therapeutics, Yamagata University School of Medicine, Yamagata, Japan.
Togashi
Hitoshi
H
Takahashi
Kazuei
K
Onodera
Yuya
Y
Sanjo
Mai
M
Misawa
Keiko
K
Suzuki
Akihiko
A
Adachi
Tohru
T
Ito
Junitsu
J
Okumoto
Kazuo
K
Hattori
Etsuko
E
Takeda
Tadashi
T
Watanabe
Hisayoshi
H
Saito
Koji
K
Saito
Takafumi
T
Sugai
Yukio
Y
Kawata
Sumio
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D037263:Asialoglycoprotein Receptor / Q000032:analysis*; D018450:Disease Progression; D005260:Female; D006521:Hepatitis, Chronic / Q000378:metabolism; D006801:Humans; D008099:Liver / Q000737:chemistry* / Q000000981:diagnostic imaging; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D015899:Tomography, Emission-Computed, Single-Photon
D037263:Asialoglycoprotein Receptor; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate