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Quantitative PET of liver functions.

Susanne Keiding1,2, Michael Sørensen1,2, Kim Frisch1

  • 1Department of Nuclear Medicine and PET Centre, Aarhus University Hospital Aarhus, Denmark.

American Journal of Nuclear Medicine and Molecular Imaging
|May 15, 2018
PubMed
Summary

Functional PET imaging offers new insights into liver function for disease treatment. Dynamic PET with tracers like 18F-FDGal and 11C-palmitate can quantify liver metabolism and transport, aiding therapeutic choices for liver diseases.

Keywords:
PET kineticsbile acid PEThepatic drug metabolismhepatic galactose PEThepatic glucose PEThepatic palmitate PEThepatobiliary excretionliver PETliver hemodynamicsliver metabolism

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Area of Science:

  • Hepatology
  • Nuclear Medicine
  • Medical Imaging

Background:

  • Accurate assessment of liver physiology and pathophysiology is crucial for developing effective therapies for liver diseases.
  • Current diagnostic methods may not fully capture the complexity of liver function, necessitating advanced imaging techniques.

Purpose of the Study:

  • To review the applications of functional Positron Emission Tomography (PET) in evaluating liver function.
  • To highlight the utility of dynamic PET imaging with specific tracers for quantifying hepatic metabolic clearance and intrahepatic transport steps.

Main Methods:

  • Dynamic PET imaging using 2-deoxy-2-[18F]fluoro-D-galactose (18F-FDGal) to assess hepatic metabolic clearance (Kmet).
  • Utilizing standard uptake value (SUV) from static 18F-FDGal PET/CT as a clinical surrogate for Kmet.
  • Employing dynamic liver PET/CT with 11C-palmitate and [N-methyl-11C]cholylsarcosine (11C-CSar) to analyze hepatic lipid and bile acid transport.
  • Developing and applying a novel microvascular compartment model to overcome limitations of standard compartment analysis in dynamic PET data.

Main Results:

  • Static 18F-FDGal PET/CT provides a clinically applicable measurement of liver metabolic function via SUV, correlating with Kmet.
  • Dynamic PET with 11C-palmitate and 11C-CSar enables detailed assessment of individual intrahepatic transport steps.
  • The new microvascular compartment model incorporates more physiological details, extracting information not obtainable with standard models.

Conclusions:

  • Static PET with 18F-FDGal offers a valuable, non-invasive method for assessing regional and whole-liver metabolic function.
  • Dynamic liver PET is instrumental in evaluating specific intrahepatic transport processes, demonstrating significant diagnostic potential for personalized patient care.