Technetium-99m NGA functional hepatic imaging: preliminary clinical experience

Area of Science:

• Nuclear medicine
• Hepatology
• Radiopharmaceutical development

Background:

• Assessing liver function noninvasively is crucial for managing liver diseases.
• Technetium-99m galactosyl-neoglycoalbumin ([Tc]NGA) targets hepatic binding protein on hepatocytes.
• A kinetic model of [Tc]NGA can quantify liver function parameters.

Observation:

• [Tc]NGA liver imaging provided diagnostic anatomic detail comparable to CT, angiography, ultrasound, and sulfur colloid scintigraphy.
• Kinetic modeling estimated standardized hepatic blood flow (Q) and hepatic binding protein concentration ([HBP]).
• Eighteen patients with various liver conditions (hepatoma, metastases, cirrhosis, hepatitis) were studied.

Findings:

• [Tc]NGA imaging demonstrated diagnostic quality comparable to established modalities.
• Significant correlation was found between estimated [HBP] and Child-Turcotte criteria scores (rs = -0.72, p = 0.001).
• [HBP] estimates are proposed as a measure of functional hepatocyte mass.

Implications:

• [Tc]NGA kinetic modeling provides a noninvasive method to assess functional hepatocyte mass.
• Combined decreased Q and reduced [HBP] may indicate poor prognosis, as seen in patients who died of hepatic failure.
• [Tc]NGA shows promise for evaluating liver function and prognosis in patients with liver disease.