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Quantitation of Liver and Spleen Uptake of ^99mTc-Phytate Colloid Using SPECT: Detection of Liver Cirrhosis

¹ Department of Nuclear Medicine, Bnai Zion Medical Center, Technion-Israel Institute of Technology, Haifa, Israel
² Liver Unit, Bnai Zion Medical Center, Technion-Israel Institute of Technology, Haifa, Israel

The purpose of this study was to assess the diagnostic performance of quantitative SPECT of ^99mTc-phytate colloid in detecting liver cirrhosis and to assess the correlation between the SPECT results and the severity of disease. Methods: Quantitative SPECT was performed on 60 patients (38 men, 22 women; mean age, 62.4 y) with liver cirrhosis and 36 control patients (21 men, 15 women; mean age, 58.7 y) without liver cirrhosis, and the results for the 2 groups were compared. Correlation with Child–Pugh classification and receiver operating characteristic methodology was used to analyze the results. Results: Cirrhotic livers had a lower total uptake than did control livers (35.6% ± 13.5% vs. 61.6% ± 10.2%, P < 0.0001). This reduced uptake was associated with a significantly reduced percentage injected dose per cubic centimeter (%ID/cm³) (0.024 ± 0.01 vs. 0.044 ± 0.01, P < 0.0001). The volume, 1,467 ± 348 cm³, was similar to that of control livers (1,487 ± 397 cm³, P = 0.80). Total uptake in the spleen was significantly greater in patients with cirrhosis than in control patients (24.9% ± 12% vs. 7.6% ± 3.2%, P < 0.0001) because of an increased volume (833 ± 460 cm³ vs. 239 ± 90 cm³, P < 0.0001). The %ID/cm³ of spleen tissue was 0.033 ± 0.01, which was similar to the value in control patients (0.032 ± 0.01, P = 0.88). Spleen volume showed the best performance in detecting liver cirrhosis, with a mean area under the curve of 0.97 (95% CI = 0.91–0.99). The severity of liver disease correlated better with total liver uptake (r = -0.68, 95% CI = -0.80 to -0.52, P < 0.0001). Conclusion: Individual SPECT quantitation of ^99mTc-phytate colloid uptake in the liver and spleen could be used as a noninvasive method to separate normal from cirrhotic livers and to evaluate the severity of disease.

Key Words: liver cirrhosis • SPECT • radionuclide • ^99mTc-phytate • quantitation