title: Technetium-99m labelled red blood cells scintigraphy and not iminodiacetic acid cholescintigraphy facilitates the discrimination of hepatic cirrhosis from fibrosis.
abstract: OBJECTIVE
  This pilot study was designed to investigate the efficacy of technetium-99m labelled red blood cells ((99m)Tc-RBC) compared with (99m)Tc-mebrofenin cholescintigraphy ((99m)Tc-MHS), in the diagnosis of hepatic dysfunction at early stages.
  
  
  METHODS
  Twenty four patients, 8 with hepatic fibrosis and 16 with cirrhosis, at Child-Pugh stage A to C and 20 age-matched controls were examined by (99m)Tc-RBC and by (99m)Tc-MHS. Dynamic acquisition and static images were semiquantitatively analused by studying the liver-to-heart (L/H) ratio estimated by both the (99m)Tc-RBC and (99m)Tc-MHS methods. The L/H ratios were compared between fibrosis, cirrhotic stages and controls, by Student's t test. Linear regression analysis of the L/H ratios for both methods has been applied in the whole study population.
  
  
  RESULTS
  Labelled RBC could statistically differentiate fibrotic from normal liver parenchyma (P<0.001), whereas the (99m)Tc-MHS could not (P: 0.13). The L/H ratios of cirrhotic lesions using both methods were significantly lower than those in controls: (P<0.000001 for (99m)Tc-RBC and P<0.0001 for (99m)Tc-MHS). Statistically significant difference was demonstrated by both modalities between fibrotic and cirrhotic lesions ((99m)Tc-RBC: P: 0.003 and (99m)Tc-MHS: P: 0.024).
  
  
  CONCLUSIONS
  Our study although in a limited number of patients suggested that as opposed to (99m)Tc-MHS, scintigraphic evaluation by (99m)Tc-RBC could be useful in the discrimination of patients with liver fibrosis, cirrhosis and normal controls.
authors.affiliation: Nuclear Medicine Department, University General Hospital "Alexandra", Vas. Sofias 80 Ave. & K. Lourou, 11528, Athens, Greece. vpapantoniou@gmail.com.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Papantoniou
authors.forename: Pipitsa
authors.initials: P
authors.lastname: Valsamaki
authors.forename: Lamprini
authors.initials: L
authors.lastname: Skorda
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papantoniou
authors.forename: Zisis
authors.initials: Z
authors.lastname: Delichas
authors.forename: George
authors.initials: G
authors.lastname: Zacharakis
authors.forename: Spyridon
authors.initials: S
authors.lastname: Michopoulos
authors.forename: Meletios
authors.initials: M
authors.lastname: Dimopoulos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Koskinas
mesh_terms: D000814:Aniline Compounds; D001652:Bile Ducts / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004912:Erythrocytes / Q000000981:diagnostic imaging*; D005260:Female; D005998:Glycine; D006801:Humans; D007098:Imino Acids; D007553:Isotope Labeling; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015609:Organotechnetium Compounds; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013667:Technetium
chemical_list: D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013667:Technetium; C034837:technetium Tc 99m mebrofenin; D005998:Glycine; C008109:iminodiacetic acid