title: Specific 99mTC-HEPIDA hepatic clearance--essential value ranges from a clinical stand-point.
abstract: BACKGROUND
  Determinations of plasma 99mTc-HEPIDA clearance (ClPl) have been performed in some centres for 30 years to assess liver parenchyma damage, mostly for monitoring of organ performance in the course of various diseases. The main disadvantage of such a procedure rests with the fact that elimination of the compound from the system occurs not only via the liver and gall ducts, but also via the urinary route; the contribution of the latter compound being quite variable. This circumstance may lead to false assessment of liver parenchyma performance. A method has been developed therefore for assessment of specific hepatic clearance of 99mTc-HEPIDA (Cl(Hp)). Using this method it was demonstrated that results of Cl(Hp) correlated better with independently assessed degrees of liver impairment than did the values of ClPl.
  
  
  METHODS
  To delineate ranges of Cl(Hp) that would provide valuable clinical information 134 individuals were studied, of whom 48 served as healthy controls and 86 had varying degrees of livers function impairment, resulting from various chronic diseases affecting the organs functional capacity. The latter was assessed on the basis of a series of commonly used biochemical indicators.
  
  
  CONCLUSIONS
  For delineation of meaningful ranges of 99mTc-HEPIDA specific hepatic clearance ROC curve method was used. The following results were obtained: Cl(Hp) >or= 150 ml min(-1) 1.72 m(-2)--excludes with high probability presence of substantial liver parenchyma damage; Cl(Hp) <or= 120 ml min(-1) 1.72m(-2)--indicates a substantial impairment of liver function (damage). Values of Cl(Hp) <or= 90 ml min(-1) 1.72 m(-2) are highly specific for serious liver damage, of intensity typical for cirrhosis of the organ.
authors.affiliation: Department of Nuclear Medicine, Central Clinical Hospital, Medical University of Lodz, Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Frieske
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Surma
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Bieńkiewicz
authors.forename: Jacek
authors.initials: J
authors.lastname: Kuśmierek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007098:Imino Acids / Q000737:chemistry / Q000493:pharmacokinetics*; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis; D008111:Liver Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000737:chemistry / Q000493:pharmacokinetics*; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012680:Sensitivity and Specificity
chemical_list: D007098:Imino Acids; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C483504:technetium Tc 99m 2,6-dimethylacetanilideiminodiacetic acid