technetium-tc-99m-mebrofenin and Liver-Diseases

A study was undertaken to check the feasibility of measuring the hepatic extraction fraction (HEF) and excretion T-1/2 values as an integral part of hepatobiliary imaging with technetium-99m-mebrofenin in health and disease. In 18 controls subjects, the HEF was 100% and the T-1/2 excretion mean +/- s.e. value was 15.23 +/- 1.4 min. The mean appearance times of the common bile duct (CBD), gallbladder (GB), and small intestine were 15.8 +/- 1.52, 20.2 +/- 2.7, and 23.8 +/- 3.08 min, respectively. Rising serum bilirubin in patients decreased HEF and increased T-1/2 excretion value resulting in delayed appearance of CBD, GB, and small intestine. In control subjects and patients with bilirubin less than 5 mg%, T-1/2 excretion values at 30, 40, and 50 min were similar to those values calculated using the entire 60 min of data, suggesting that the hepatic phase study time could be reduced to 30-40 min and still use the normal reference values established for 60 min. In patients with bilirubin greater than 5 mg%, the data collection duration should be continued for 60 min.

Topics: Aniline Compounds; Biliary Tract; Biliary Tract Diseases; Bilirubin; Female; Glycine; Humans; Imino Acids; Liver; Liver Diseases; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Reference Values; Time Factors

Topics: Elasticity Imaging Techniques; Humans; Liver; Liver Cirrhosis; Liver Diseases; Prospective Studies; Radionuclide Imaging

Preoperative portal vein embolization (PVE) is performed in patients with insufficient future remnant liver (FRL) to allow safe resection. Although many studies have demonstrated an increase in FRL volume after PVE, little is known about the increase in FRL function. This study evaluated the increase in FRL function after PVE using (⁹⁹m) Tc-labelled mebrofenin hepatobiliary scintigraphy (HBS) with single photon emission computed tomography (SPECT) and compared this with the increase in FRL volume.. In 24 patients, computed tomography volumetry and (⁹⁹m) Tc-labelled mebrofenin HBS with SPECT were performed before and 3-4 weeks after PVE to measure FRL volume, standardized FRL and FRL function. A hypothetical model was used to assess safe resectability after PVE. The limit for safe resection for FRL function was set at an uptake of 2·69 per cent per min per m². For FRL volume and standardized FRL, 25 or 40 per cent of total liver volume was used, depending on the presence of underlying liver disease.. After PVE, FRL function increased significantly more than FRL volume. The correlation between the increase in FRL volume and FRL function was poor. Using the hypothetical model, seven patients did not achieve a sufficient increase in FRL function to allow safe resection 3-4 weeks after PVE, compared with 12 and nine patients based on FRL volume and standardized FRL respectively.. The increase in FRL function after PVE is more pronounced than the increase in FRL volume, suggesting that the necessary waiting time until resection may be shorter than indicated by volumetric parameters.

Topics: Adult; Aged; Aniline Compounds; Embolization, Therapeutic; Female; Glycine; Hepatectomy; Humans; Imino Acids; Liver Diseases; Liver Function Tests; Male; Middle Aged; Organ Size; Organotechnetium Compounds; Portal Vein; Preoperative Care; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Early postoperative hepatobiliary scintigraphy after liver transplantation is performed worldwide, but data on its significance for graft function are currently limited.. To examine the correlation between the result of early postoperative hepatobiliary scintigraphy and pre- and postoperative biochemical parameters in liver transplantation (LTx) patients.. Six parameters of hepatobiliary scintigraphy using (99m)Tc mebrofenin were statistically analyzed in 108 LTx patients: 1) half-life of the activity of elimination of mebrofenin from the blood; 2) total clearance of mebrofenin from the blood due to all possible routes; 3) half-life of the activity due to liver uptake; 4) clearance of mebrofenin from the blood due to liver uptake; 5) time to maximal uptake in the liver; and 6) the hepatic extraction fraction (HEF) and biochemical data. Analysis between patients with preoperative normal liver function, familial amyloid polyneuropathy (FAP), and end-stage liver disease (non-FAP) was also performed.. Univariate and multivariate analysis revealed that total bilirubin postoperative day 3 correlated with all three scintigraphic parameters, and peak aspartate aminotransferase and alanine aminotransferase correlated with HEF. The analysis between patients with FAP and non-FAP revealed no significant difference of scintigraphic data between the two groups.. A significant correlation between early postoperative scintigraphic results and biochemical parameters was demonstrated.

Topics: Adolescent; Adult; Aged; Alanine Transaminase; Amyloid Neuropathies, Familial; Aniline Compounds; Aspartate Aminotransferases; Biliary Tract; Bilirubin; Biomarkers; Child; Child, Preschool; Female; Glycine; Humans; Imino Acids; Liver; Liver Diseases; Liver Function Tests; Liver Transplantation; Male; Middle Aged; Organotechnetium Compounds; Postoperative Period; Predictive Value of Tests; Radionuclide Imaging; Retrospective Studies; Time

The main aim of this study was to investigate the role of N-(2,4,6 trimethyl-3-bromophenylcarbamoylmethyl) iminodiacetic acid (IDA; Mebrofenin) scintigraphy in follow-up assessments of the biliary system in patients with cystic fibrosis associated liver disease. Fourteen patients from a study published in 1996 were re-examined after a mean interval of 4.7 years from their initial study, in which diisopropylphenyl carboxymethyl iminodiacetic acid (DISIDA) was used. The results of ultrasound, liver function tests and clinical examination were also compared. Twelve of the patients had been treated with ursodeoxycholic acid and taurine in the interim. Five subjects' IDA examinations showed a slight improvement on follow-up, six deteriorated, two were unchanged, whilst one demonstrated a 'mixed picture'. Overall, nine patients deteriorated in one or more of the tests. No patient showed a decline in all four investigations and only two in three. There was poor correlation between the various follow-up examinations, with different patients showing a decline in some tests but not others. This may be due to the mixture of functional and anatomical studies utilized, their differing sensitivies, and the fact that deterioration in one did not necessarily affect another. In conclusion, follow-up of hepatobiliary disease in patients with cystic fibrosis cannot be encompassed by one method alone. If early detection of disease progression would affect management, patients will continue to require a number of investigations rather than a single test.

Topics: Adolescent; Adult; Aniline Compounds; Child; Cystic Fibrosis; Female; Follow-Up Studies; Glycine; Humans; Imino Acids; Liver Diseases; Male; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity

Topics: Aniline Compounds; Bile Ducts, Intrahepatic; Cholestasis, Extrahepatic; Cholestasis, Intrahepatic; Cysts; Female; Glycine; Humans; Imino Acids; Jaundice; Liver; Liver Diseases; Middle Aged; Organotechnetium Compounds; Polycystic Kidney Diseases; Radionuclide Imaging; Radiopharmaceuticals

Topics: Adult; Aniline Compounds; Biliary Tract; Biliary Tract Diseases; Child; Glycine; Humans; Imino Acids; Liver; Liver Diseases; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Disofenin

After a motor vehicle accident, an 18-year-old woman reported cough and dyspnea. A chest radiograph revealed an intrathoracic mass blending with the cardiac shadow. Hepatobiliary imaging showed that this was due to herniation of the left hepatic lobe and a portion of the right lobe and gallbladder into the right hemithorax.

Topics: Adolescent; Aniline Compounds; Female; Gallbladder Diseases; Glycine; Hernia; Hernia, Diaphragmatic, Traumatic; Humans; Imino Acids; Liver Diseases; Organotechnetium Compounds; Radionuclide Imaging; Thorax

A prospective study was performed on 14 patients with histologically proven focal nodular hyperplasia (FNH) using a hepatobiliary scan with trimethylbromoimino-diacetic acid (TBIDA) and a colloid scan with rhenium sulfur colloids. TBIDA uptake was relatively normal in the region of the tumor, but during the clearance phase 23/25 of the tumors were detected by a hot spot of radioactivity. Depending on the relative contrast achieved between the tumor and normal liver, this hot spot appeared early or later, but was always present at 60 min. In three tumors, a "doughnut" pattern was observed within the hot spot due to a central defect. Hypervascularization was observed during the perfusion phase in 76% of the tumoral sites and normal colloid uptake in only 64%. The detectability of FNH appears greater with TBIDA (92%) than with CT or MRI (84%). The high prevalence of hot spots may be due to careful technological conditions when obtaining hepatobiliary scans. Late images, overexposed films, multiple views and stimulation of gallbladder excretion increased tumor detectability. The hot spot sign may be a useful tool when combined with the results of other imaging modalities in the diagnosis of FNH. The peculiar pathology of FNH with fibrosis, hyperplastic hepatocytes and cholangiolar proliferation might explain this scintigraphic appearance.

Topics: Adult; Aniline Compounds; Biliary Tract; Female; Glycine; Humans; Imino Acids; Liver; Liver Diseases; Magnetic Resonance Imaging; Middle Aged; Organotechnetium Compounds; Prospective Studies; Radionuclide Imaging; Rhenium; Sensitivity and Specificity; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Six healthy individuals and six patients with a wide range of hepatobiliary function abnormalities were studied with Tc-99m-trimethylbromo-IDA; all normal subjects and four of the six patients were also studied with Tc-99m-diisopropyl-IDA. Visual evaluation of analog images demonstrated a greater liver-to-kidney ratio for Tc-99m-trimethylbromo-IDA (p less than 0.01). Sampling for radiopharmaceutical in urine at three hours following injection demonstrated that Tc-99m-trimethylbromo-IDA had a lower renal excretion rate than Tc-99m-diisopropyl-IDA regardless of whether hepatocyte function was normal or abnormal (p less than 0.01). There were no significant differences between the two radiopharmaceuticals in hepatocyte extraction efficiency or hepatic parenchymal transit time. It is concluded that the lower rate of renal excretion and, therefore, greater hepatocyte specificity of Tc-99m-trimethylbromo-IDA justifies expanded clinical trials and may make it the radiopharmaceutical of choice for hepatobiliary imaging.

Topics: Adult; Aniline Compounds; Biliary Tract; Biliary Tract Diseases; Drug Evaluation; Glycine; Humans; Imino Acids; Liver; Liver Diseases; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin