Utility of quantitative 99mTc-phytate scintigraphy to diagnose early-stage non-alcoholic steatohepatitis.
OBJECTIVE
In patients with non-alcoholic fatty liver disease (NAFLD), liver biopsy remains the only reliable method to differentiate simple steatosis from non-alcoholic steatohepatitis (NASH). The objective of this study was to evaluate the efficacy of non-invasive (99m)Tc-phytate scintigraphy in the diagnosis of NASH.


METHODS
Thirty-seven patients with suspected NAFLD at the time of liver biopsy also underwent (99m)Tc-phytate scintigraphy. Signal intensities of regions of interest (ROI) in the liver, spleen, and heart were measured. We also examined scintigraphic features in a nutritional model of NASH in rats fed a methionine- and choline-deficient (MCD) diet.


RESULTS
The liver/spleen uptake ratio determined by scintigraphy was significantly decreased in patients with NASH in comparison with patients with simple steatosis. The liver/spleen ratio was an independent predictor distinguishing NASH from simple steatosis. The decrease was observed for all stages of NASH, including the early stage (stages 1 and 0). In animal studies, the liver/spleen uptake ratio was significantly decreased in rats after 8 weeks of MCD dietary feeding in comparison with control diet-fed rats.


CONCLUSIONS
The non-invasive (99m)Tc-phytate scintigraphy test is a reliable tool to differentiate NASH from simple steatosis.
Kikuchi
Masahiro
M
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Tomita
Kengo
K
Nakahara
Tadaki
T
Kitamura
Naoto
N
Teratani
Toshiaki
T
Irie
Rie
R
Yokoyama
Hirokazu
H
Suzuki
Takahiro
T
Yokoyama
Terufumi
T
Taguchi
Takashi
T
Tanaka
Shinobu
S
Noguchi
Masaaki
M
Ohkura
Tamiko
T
Hibi
Toshifumi
T
D000328:Adult; D000818:Animals; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D051381:Rats; D017208:Rats, Wistar; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013667:Technetium
D019275:Radiopharmaceuticals; D013667:Technetium