A non-invasive isotope dilution technique for quantifying hepatic blood flow using radiolabelled red blood cells

A non-invasive isotope dilution technique for quantifying hepatic blood flow using radiolabelled red blood cells

Clinically significant changes in hepatic haemodynamics accompany the development of portal hypertension, hepatocellular carcinoma, liver metastases and liver cirrhoses, and after major liver resection. Hepatic blood flow parameters, such as hepatic arterial flow (HAF), hepatic portal flow (HPF), to...

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Bibliographic Details
Published in:Nuclear medicine communications Vol. 21; no. 3; pp. 269 - 276
Main Authors: YU, W K, CHOW, P KH, SOMANESAN, S, NG, T H, SUNDRAM, F X, CHAN, S TF, SOO, K C, AW, S E, SHAW, S M
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-03-2000
Lippincott Williams & Wilkins
Subjects:
Animals
Biological and medical sciences
Erythrocytes - physiology
Hepatic Artery - physiology
Investigative techniques, diagnostic techniques (general aspects)
Liver Circulation - physiology
Medical sciences
Portal Vein - physiology
Radioisotope Dilution Technique
Radionuclide investigations
Radiopharmaceuticals - blood
Swine
Technetium Tc 99m Disofenin
Time Factors
Urinary system
Parameter estimation
Radiolabelling
Isotope dilution
Technetium
Clearance
Real time system
Kidney
Blood flow
Pig
Vertebrata
Mammalia
Urinary system
Animal
Artiodactyla
Hemodynamics
Technique
Ungulata
Quantitative analysis
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Summary:Clinically significant changes in hepatic haemodynamics accompany the development of portal hypertension, hepatocellular carcinoma, liver metastases and liver cirrhoses, and after major liver resection. Hepatic blood flow parameters, such as hepatic arterial flow (HAF), hepatic portal flow (HPF), total hepatic blood flow (THBF) and hepatic perfusion index (HPI), are useful adjuncts to the diagnosis of liver pathology, the evaluation of disease progress and prognostication. Here, we describe a non-invasive method that combines the measurement of these parameters in a single study in real time.Red blood cells from eight pigs were labelled with Tc using an in-vitro method and re-injected into the pigs. Data acquisition over the heart, lungs, liver and kidneys was started immediately and a blood sample was obtained 15 min post-injection. Hepatic arterial flow was determined from the ratio of the maximum gradients between the integrated time-activity curve of the left ventricle and the first-pass time-activity curve of the liver before the peak of the kidneys time-activity curve. The hepatic perfusion index was determined by comparing the slope of the liver time-activity curve before and after the kidney peak. Hepatic portal flow was determined from the hepatic arterial flow and the hepatic perfusion index, and total hepatic blood flow was determined as the sum of arterial and portal flow. The results were compared against those obtained from a clearance method using Tc-DISIDA.The average hepatic perfusion index was 0.38, and the average hepatic arterial flow and hepatic portal flow were 168.3±52.9 and 274.6±60.1 ml·min respectively. The average total hepatic blood flow was 442.8±53.5 ml·min, while the total hepatic flow determined by Tc-DISIDA clearance was 419.7±62.6 ml·min. No significant difference in total hepatic blood flow was found between the two methods. The results of this study show that it is possible to obtain all hepatic haemodynamics data in a single study using a non-invasive method.
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ISSN:0143-3636
1473-5628
DOI:10.1097/00006231-200003000-00011