title: Utility of quantitative 99mTc-phytate scintigraphy to diagnose early-stage non-alcoholic steatohepatitis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Kengo
authors.initials: K
authors.lastname: Tomita
authors.forename: Tadaki
authors.initials: T
authors.lastname: Nakahara
authors.forename: Naoto
authors.initials: N
authors.lastname: Kitamura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Teratani
authors.forename: Rie
authors.initials: R
authors.lastname: Irie
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Terufumi
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Taguchi
authors.forename: Shinobu
authors.initials: S
authors.lastname: Tanaka
authors.forename: Masaaki
authors.initials: M
authors.lastname: Noguchi
authors.forename: Tamiko
authors.initials: T
authors.lastname: Ohkura
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D013667:Technetium