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A novel liver function evaluation system using radiopharmacokinetic modeling of technetium-99m-DTPA-galactosyl human serum albumin

Du, Shundaa*; Mao, Yileia; Tong, Junxiangc*; Li, Fangb; Che, Lua; Li, Shaohuaa; Yang, Huayua; Ba, Jiantaob; Hu, Nanb; Xing, Haiqunb; Lu, Xina; Sang, Xintinga; Zhang, Xianzhongd,e; Wang, Xuebind; Zhong, Shouxiana

doi: 10.1097/MNM.0b013e328362e7c7
Original Articles

Background: A new kinetic model of technetium-99m-labeled diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) was developed to show the speed of asialoglycoprotein receptor-mediated endocytosis.

Materials and methods: Ten healthy volunteers and 17 patients with liver cirrhosis were intravenously injected with 185 MBq of 99mTc-GSA, and dynamic planar images were acquired. The absolute amounts of 99mTc-GSA in the liver and extrahepatic blood were estimated from the time–activity curves for the liver, heart, and lungs. A two-compartment model was represented with two parameters as variables to estimate the uptake index (UI) of 99mTc-GSA transport through the hepatic cell membrane from the total plasma at any given time.

Results: The dynamic curve of 99mTc-GSA uptake by the liver was generated. Analysis of individuals with normal livers and patients with liver cirrhosis showed statistically significant differences in their UI. The UI for normal livers was high and that for cirrhotic livers was low. Linear regression correlation of UI with albumin, prealbumin, and prothrombin time was 0.841, 0.746, and −0.723, respectively.

Conclusion: UI reflects the cellular transport of asialoglycoproteins as ascertained by the two-compartment model on the basis of GSA dynamic images. It is useful for measuring liver function.

Departments of aLiver Surgery

bNuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences and PUMC

cDepartment of Hepatobiliary Surgery, General Hospital of Chinese PLA

dKey Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing

eSchool of Public Health, Center for Molecular Imaging and Translational Medicine, Xiamen University, Xiamen, China

*Shunda Du and Junxiang Tong contributed equally to the writing of this article.

Correspondence to Yilei Mao, MD, PhD, Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences and PUMC, 1# Shuai-Fu-Yuan, Wang-Fu-Jing, Beijing 100730, China Tel: +86 10 69156042/+86 13011079603; fax: +86 10 69156043; e-mail: yileimao@126.com

Received November 25, 2012

Accepted May 1, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins