Tc-99m-二乙烯三胺五乙酸半乳糖基人血清白蛋白SPECT/CT定量评估在鉴别严重肝纤维化中的实用性：与其他肝功能指标的互补诊断价值。

IF 3 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Molecular Imaging and Biology Pub Date : 2024-10-10 DOI:10.1007/s11307-024-01958-2

Yoichi Kozaki, Yasutaka Ichikawa, Satoshi Nakamura, Tatsuhiro Kobayashi, Yoya Tomita, Motonori Nagata, Naohisa Kuriyama, Shugo Mizuno, Hajime Sakuma

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引用次数: 0

摘要

目的：评估锝-99m-二乙烯三胺-五乙酸-半乳糖基人血清白蛋白（99m锝-GSA）单光子发射计算机断层扫描（SPECT）在评估肝纤维化方面的价值，并评估其与纤维化-4（FIB-4）指数和吲哚菁绿（ICG）清除试验参数（ICG-R15和ICG-K）等其他肝功能指标的互补价值：研究对象： 78名慢性肝病和肝细胞癌患者，他们在肝切除术前接受了99m锝-GSA闪烁成像和其他肝功能检测，包括ICG检测和FIB-4指数。99mTc-GSA 显像是通过 SPECT/CT 扫描仪（Discovery NM/CT 670）进行的。注射 99mTc-GSA 后，立即进行 20 分钟的动态成像，然后进行 6 分钟的 SPECT 数据采集。LHL15是99m锝-GSA平面图像的常规指标，肝脏摄取率（LUR）则是通过99m锝-GSA SPECT图像测量的。肝切除标本的肝纤维化程度根据路德维希量表（F0-4）进行分级：结果：F0-3和F4肝纤维化患者组之间在LUR、LHL15、ICG-R15、ICG-K、血小板计数和FIB-4指数方面存在显著差异（P通过99m锝-GSA SPECT测量的LUR是鉴别严重肝纤维化的有效指标。特别是对于FIB-4指数较高（≥3.16）的患者，LUR可作为鉴别严重肝纤维化的重要指标，诊断准确率较高。

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Utility of Quantitative Assessment of Tc-99m-diethylenetriamine-penta-acetic acid-galactosyl Human Serum Albumin SPECT/CT in the Identification of Severe Liver Fibrosis: Its Complementary Diagnostic Value with Other Liver Function Indices.

Purpose: To evaluate the value of Tc-99m-diethylenetriamine-penta-acetic acid-galactosyl human serum albumin (^99mTc-GSA) single photon emission computed tomography (SPECT) for assessing liver fibrosis, and to assess its complementary value to other liver function indices such as fibrosis-4 (FIB-4) index and indocyanine green (ICG) clearance test parameters (ICG-R15 and ICG-K).

Procedures: Seventy-eight patients with chronic liver disease and hepatocellular carcinoma who underwent ^99mTc-GSA scintigraphy and other liver function tests including ICG test and FIB-4 index prior to hepatectomy were studied. ^99mTc-GSA imaging was performed with SPECT/CT scanner (Discovery NM/CT 670). Immediately after injection of ^99mTc-GSA, dynamic imaging was performed for 20 min, followed by SPECT data acquisition for 6 min. LHL15 which is a conventional index by ^99mTc-GSA planar images, and liver uptake ration (LUR) was measured from ^99mTc-GSA SPECT images. From the liver resection specimens, the degree of liver fibrosis was graded according to the Ludwig scale (F0-4).

Results: Significant differences in LUR, LHL15, ICG-R15, ICG-K, platelet count and FIB-4 index were found between the F0-3 and F4 liver fibrosis patient groups (P < 0.05). Multivariate logistic regression analysis revealed that LUR and ICG-K were independent factors for identifying severe liver fibrosis (F4). Area under the curve of receiver operating curve analysis for the logistic regression model using LUR and ICG-K was 0.83. In the patient group with higher FIB-4 (≥ 3.16), the diagnostic performance of LUR for detecting severe liver fibrosis was significantly better than LHL15 (AUC: 0.83 vs. 0.75, P = 0.048). In the high FIB-4 index group, the sensitivity and specificity for identifying F4 was 88% and 85%, respectively, with LUR cutoff value of 41.2%.

Conclusions: LUR, measured by ^99mTc-GSA SPECT, is a useful indicator for identifying sever liver fibrosis. Particularly in patients with high FIB-4 index (≥ 3.16), LUR can be a valuable indicator to identify severe liver fibrosis with high diagnostic accuracy.

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来源期刊

Molecular Imaging and Biology 医学-核医学

CiteScore

6.90

自引率

3.20%

发文量

审稿时长

3 months

期刊介绍： Molecular Imaging and Biology (MIB) invites original contributions (research articles, review articles, commentaries, etc.) on the utilization of molecular imaging (i.e., nuclear imaging, optical imaging, autoradiography and pathology, MRI, MPI, ultrasound imaging, radiomics/genomics etc.) to investigate questions related to biology and health. The objective of MIB is to provide a forum to the discovery of molecular mechanisms of disease through the use of imaging techniques. We aim to investigate the biological nature of disease in patients and establish new molecular imaging diagnostic and therapy procedures. Some areas that are covered are: Preclinical and clinical imaging of macromolecular targets (e.g., genes, receptors, enzymes) involved in significant biological processes. The design, characterization, and study of new molecular imaging probes and contrast agents for the functional interrogation of macromolecular targets. Development and evaluation of imaging systems including instrumentation, image reconstruction algorithms, image analysis, and display. Development of molecular assay approaches leading to quantification of the biological information obtained in molecular imaging. Study of in vivo animal models of disease for the development of new molecular diagnostics and therapeutics. Extension of in vitro and in vivo discoveries using disease models, into well designed clinical research investigations. Clinical molecular imaging involving clinical investigations, clinical trials and medical management or cost-effectiveness studies.