title: A quantitative index measured on ⁹⁹mTc GSA SPECT/CT 3D fused images to evaluate severe fibrosis in patients with chronic liver disease.
abstract: OBJECTIVE
  We compared quantitative indices estimated by use of technetium-(99m) galactosyl human serum albumin ((99m)Tc-GSA) single-photon emission computed tomography (SPECT)/computed tomography (CT) fused imaging and hepatic fibrosis in patients with chronic liver disease.
  
  
  METHODS
  On the basis of pathological findings we divided 161 patients into non-severe and severe fibrosis groups (n = 81 and n = 80, respectively). We measured 2 indices by (99m)Tc-GSA SPECT/CT fused imaging: liver uptake value (LUV) = [radioactivity (whole liver)/radioactivity (injected)] × 100/body surface area, and functional liver index (FLI) = [radioactivity (hepatocytes)/radioactivity (injected)] × 100/liver volume. We compared these indices with biochemical and histopathological results.
  
  
  RESULTS
  Univariate and multivariate analyses showed that FLI, LUV, LHL15, and prothrombin time were significant independent predictors of severe fibrosis. On the basis of receiver operating characteristics analysis, the areas under curve values of FLI, LUV, LHL15, and prothrombin time for predicting severe fibrosis were 0.83, 0.73, 0.69, and 0.68, respectively. Using an FLI value of 0.053, it was possible to predict severe fibrosis with 65 % sensitivity, 88 % specificity, and 76 % accuracy.
  
  
  CONCLUSIONS
  Assessment of functional hepatocytes by use of (99m)Tc-GSA SPECT/CT fused images is useful for identifying pathological liver fibrosis.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. y_morikatsu@hotmail.com
authors.forename: Morikatsu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Shinya
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Fumi
authors.initials: F
authors.lastname: Sakaguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Utsunomiya
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Tashiro
authors.forename: Seiji
authors.initials: S
authors.lastname: Tomiguchi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging*; D008111:Liver Function Tests; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate