Quantification of intrahepatic non-uniform distributions for assessing impaired function of liver using 99Tcm-DTPA-galactosyl serum albumin liver SPECT scintigraphy.

Quantitative evaluation of intrahepatic non-uniform distribution was attempted by functional volumetric analysis of liver single photon emission computed tomography (SPECT) scintigraphy using 99 Tc m -diethylenetriaminepentaacetic acid galactosyl serum albumin ( 99 Tc m -GSA) (185 MBq). A total of 148 patients were classified into three groups: diffuse liver disease, liver disease with space-occupying lesions, and non-hepatic disease. The volume obtained at the 10% cut-off threshold from reconstructed liver-specific SPECT images was assumed to be the functional total hepatic volume, and the functional volume rates were calculated every 10% threshold width from 10% to 100%. The hepatic distribution index (D index) was calculated from the sum of absolute differences from the control. The hepatic D index in liver cirrhosis was significantly higher than in hepatitis and other diffuse liver diseases, and the index in liver disease with primary malignant neoplasm was significantly higher than in liver disease with metastasis or a benign-space occupying lesion. Additionally, it was significantly negatively correlated with LHL15, and positively correlated with the clinical severity. However, in stages II and III, with which LHL15 did not significantly correlate, the hepatic D index matched the severity of hepatic impairment. The hepatic D index evaluates distribution of functional hepatocytes and may provide a new clinical method for quantitatively assessing hepatic impairment.