Factors affecting the quantitative liver-spleen scan in normal individuals.
The quantitative liver-spleen scan (QLSS) can estimate the functional hepatic mass and the organ volumes by precise measurement of sulfur colloid (SC) distribution. The normal range determined in prior studies was estimated from patients with absence of chronic liver disease in which intense fasting appeared to produce slightly abnormal values. This study was to determine the effect of fasting or fed status and colloid particle size on quantitative measurements from the QLSS in a small cohort of normal individuals. Twelve persons without any medical problems had QLSS taken twice, 2 weeks apart, one fasting and one postprandial. Patients were scanned after injection of 5-6 mCi of SC; six patients were given solution A (5- to 12-microm particle size) and six patients solution B (2- to 12-microm particle size). SPECT and planar analysis were performed. SC distribution of total counts between the liver and the spleen {[L/(L + S)]t ratio}, liver-spleen index (LSI), and liver-bone marrow index (LBI) were calculated. The perfused hepatic mass (PHM) is the average of the LSI and LBI. Spleen and liver volumes are expressed as milliliters per pound ideal body weight (IBW). Results showed that the liver and spleen volumes (solution B postprandial, 9.27 +/- 2.48 and 1.47 +/- 0.57 ml/lb IBW, respectively) and LBI were not affected by the type of SC solution or by ingestion status. L/(L + S) total and pixel count ratios were significantly higher for solution B and postprandial studies. [L/(L + S)]t, LSI, and PHM increased significantly (P < 0.05) from fasting to postprandial for solution A (0.71 +/- 0.13 vs 0.79 +/- 0.08, 80 +/- 14 vs 91 +/- 8, and 102 +/- 10 vs 106 +/- 8, respectively) and for solution B (0.81 +/- 0.05 vs 0.90 +/- 0.02, 86 +/- 4 vs 95 +/- 3, and 101 +/- 5 vs 110 +/- 3). Neither fasting nor postprandial LSI and PHM were significantly different between solution A and solution B. We conclude the following. (1) The QLSS functional indices in "true" normal patients fall within the previously reported normal range. (2) Calculated liver and spleen volumes are not altered by fasting or sulfur colloid particle size. (3) Fasting significantly decreased the [L/(L + S)]t, LSI, and PHM. (4) A postprandial scan may be preferable since the normal values for [L/(L + S)]t, LSI, and PHM are greater, with a narrower range, than fasting values.
Hoefs
John C
JC
Division of Gastroenterology/Liver Disease Program, Department of Medicine, University of California, Irvine/ UCI Medical Center, Orange, California 92868, USA. jchoefs@uci.edu
Sheikh
Muhammad Y
MY
Guerrero
Heather
H
Milne
Norah
N
D000328:Adult; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D010316:Particle Size; D019518:Postprandial Period; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013154:Spleen / Q000000981:diagnostic imaging*; D013671:Technetium Tc 99m Sulfur Colloid
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid
Gut. 1994 Feb;35(2):186-90
8307468
J Nucl Med. 1999 Oct;40(10 ):1745-55
10520718
Arch Intern Med. 1970 Dec;126(6):1031-52
4921754
Clin Nucl Med. 1981 May;6(5):204-6
6452980
Am J Gastroenterol. 1984 Dec;79(12 ):950-8
6507421
J Nucl Med. 2002 Mar;43(3):312-7
11884489
Clin Sci (Lond). 1991 Aug;81(2):169-75
1653660
Clin Nucl Med. 1983 Jun;8(6):237-8
6872391
J Clin Invest. 1954 Dec;33(12):1594-602
13211815
Br J Radiol. 1991 May;64(761):409-12
2036562
Nucl Med Commun. 1986 Jul;7(7):511-7
3774251
Acta Chir Scand. 1975;141(3):197-202
1166743
Acta Physiol Scand. 1994 Apr;150(4):363-72
8036905
Dig Dis Sci. 1995 Mar;40(3):552-60
7895543
Am J Gastroenterol. 1997 Nov;92 (11):2054-8
9362191
J Reticuloendothel Soc. 1970 Aug;8(2):176-84
5469817
Eur J Nucl Med. 1976;1(1):31-5
1017428
Eur J Nucl Med. 1978;3(1):47-54
753622
Acad Radiol. 1997 Jan;4(1):13-20
9040865
Eur J Nucl Med. 1980 Jun;5(3):241-5
7389724
Acta Med Scand Suppl. 1952;273:1-71
12996294
J Surg Res. 2000 Aug;92(2):222-7
10896825
J Nucl Med. 1996 Sep;37(9):1575-8
8790222
Dig Dis Sci. 1994 Jan;39(1):46-50
8281866
J Nucl Med. 1987 Sep;28(9):1424-9
3625295
J Surg Oncol. 2001 Dec;78(4):248-52
11745819
Acta Physiol Scand. 1992 Nov;146(3):321-7
1481689
J Hepatol. 2003 Sep;39(3):326-32
12927917
Clin Sci (Lond). 2000 Dec;99(6):517-25
11099395
Hepatology. 1995 Oct;22(4 Pt 1):1113-21
7557859
Radiology. 1976 Jan;118(1):115-9
1244641
Gastroenterology. 1976 Aug;71(2):210-3
939379
Eur J Nucl Med. 1981;6(8):371-4
6273173
Clin Cancer Res. 2003 Dec 15;9(17):6350-6
14695134
Comput Methods Programs Biomed. 1998 Aug-Sep;57(1-2):143-6
9804012
Liver. 1989 Apr;9(2):86-92
2651836