Interesting ImagesAntiviral (Hepatitis C Virus) Drug-Drug Interaction Leading to Dramatic Underestimation of Liver Function With 99mTc-Mebrofenin Hepatobiliary ScintigraphyDeshayes, Emmanuel MD, PhD*,†; Fersing, Cyril PharmD, PhD*,†; Meunier, Lucy MD, MSc‡; Quenet, François MD, PhD§; Guiu, Boris MD, PhD∥Author Information From the *Nuclear Medicine Department †Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194 Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier ‡Liver and Transplantation Unit, Montpellier School of Medicine and IRB-INSERM-1183 §Department of Surgical Oncology, ICM, Univ. Montpellier ∥Radiology Department, Montpellier Saint Eloi University Hospital, Montpellier, France. Received for publication July 2, 2019; revision accepted September 23, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Emmanuel Deshayes, MD, PhD, Nuclear Medicine Department, Institut du Cancer de Montpellier (ICM), 34298 Montpellier, France. E-mail: email@example.com. Online date: December 11, 2019 Clinical Nuclear Medicine: February 2020 - Volume 45 - Issue 2 - p 133-135 doi: 10.1097/RLU.0000000000002861 Buy Metrics Abstract There is a growing interest in assessment of future remnant liver function with 99mTc-mebrofenin hepatobiliary scintigraphy before major hepatectomy to estimate the risk of posthepatectomy liver failure. We illustrate the case of a 42-year-old woman with liver metastasis from colorectal cancer who performed hepatobiliary scintigraphy. 99mTc-mebrofenin clearance rate of the total liver was considerably low. The patient recently started a treatment for active hepatitis C with a combination of 2 new direct-acting antiviral agents (grazoprevir, elbasvir). Apart from hypoalbuminemia or hyperbilirubinemia, physicians must be aware that drug interactions can interfere with 99mTc-mebrofenin liver uptake, thereby resulting in a dramatic underestimation of liver function. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.