Evaluation of hepatic perfusion and function with modified hepatobiliary scintigraphy

Area of Science:

• Nuclear Medicine
• Hepatology
• Medical Imaging

Background:

• Hepatic cirrhosis significantly alters portal hemodynamics and hepatocellular function.
• Accurate assessment of portal vein pressure (PVP) and liver function is crucial for managing cirrhosis.

Purpose of the Study:

• To investigate the quantitative relationship between portal vein pressure (PVP) and portal vein perfusion index (PVI).
• To evaluate hepatocellular function using a modified hepatobiliary dynamic scintigraphy protocol.

Main Methods:

• A modified hepatobiliary dynamic scintigraphy using Tc-99m-labeled EHIDA was performed in 37 cirrhotic patients and 12 healthy controls.
• Portal vein pressure (PVP) was measured intra-operatively in 18 patients.
• Portal vein perfusion index (PVI) and hepatic functional indices (UI, MRI, UsI, DsI, PU, PT) were calculated using compartmental models.

Main Results:

• Cirrhotic patients exhibited significantly higher PVI compared to controls (46.17±7.83 vs. 29.07±5.71, P<0.001).
• PVI showed a strong positive correlation with PVP (r=0.79, P<0.01).
• Hepatocellular function indices like peak uptake (PU), uptake index (UI), and uptake speed index (UsI) were significantly reduced in cirrhotic patients, while peak time (PT) and mean residual index (MRI) were prolonged.

Conclusions:

• Modified quantitative hepatobiliary dynamic scintigraphy is a valuable tool for evaluating portal vein blood flow and monitoring hepatocellular function in cirrhosis.
• The portal vein perfusion index derived from this method can effectively estimate portal vein pressure.