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A Noninvasive Method for Evaluating Portal Circulation by Administration of Tl-201 per Rectum

Kanazawa University, Kanazawa, Japan

Correspondence: For reprints contact: Norihisa Tonami, MD, Dept. of Nucl. Med., School of Medicine, Kanazawa Univ., Takara-machi 13-1, Kanazawa City 920, Japan.

ABSTRACT

A new method for evaluating portal systemic circulation by administration of Tl-201 per rectum was performed in 13 control subjects and in 65 patients with various liver diseases. In normal controls, the liver was visualized on the 0–5-min image whereas the images of other organs such as the heart, spleen, and lungs were very poor. In patients with liver cirrhosis associated with portal-systemic shunt, and in many other patients with hepatocellular damage, the liver was not so clearly visualized, whereas radioactivity in other organs, especially the heart, became evident. The heart-to-liver uptake ratio at 20 min after administration (H/L ratio) was significantly higher in liver cirrhosis than in normals and patients with chronic hepatitis (p <0.001). The patients with esophageal varices showed a significantly higher H/L ratio compared with that in cirrhotic patients without esophageal varices (p <0.001). The H/L ratio also showed a significant difference (p <0.01) between Stage 1 and Stage 3 esophageal varices. Since there were many other patients with hepatocellular damage who had high H/L ratios similar to those in liver cirrhosis, the effect that hepatocellular damage has on the liver uptake of Tl-201 is also considered. Our present data suggest that this noninvasive method seems to be useful in evaluating portal-to-systemic shunting.