Abstract
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Objectives Previous publications for [Tc-99m]-mebrofenin hepatobiliary scintigraphy (HBS) have used a combination of dynamic planar and single static SPECT imaging to measure both total and segmental liver function prior to surgery or other intervention (e.g., PVE). The method of analysis usually employed is that of Ekman et al (Nucl Med Commun 1996). Patlak-Rutland graphical analysis is an alternative established method to quantify the rate of uptake which uses the full dynamic dataset and has the advantage that it can be applied at a pixel level in tomographic imaging.The aim of this study was to compare the liver clearance rate (LClr) measured by the Ekman method with uptake rate (Ki) from the Patlak-Rutland method using current imaging methodology, with a view to future implementation in dynamic SPECT imaging to provide 3D parametric images of liver function.
Methods Dynamic planar [Tc-99m]-Mebrofenin HBS with SPECT were acquired in 31 patients who were considered for liver resection (18 patients), resection with preoperative portal vein embolization (4 patients), SIR-Spheres microspheres therapy (7 patients), transcatheter arterial chemoembolization (TACE, 1 patient) or [Lu-177]-lutate therapy (1 patient). Mebrofenin extraction (%/min) was calculated by both approaches using the same regions-of-interest and compared.
Results Linear regression revealed Ki (%/min) = 1.16[asterisk]LClr-2.69; r=0.82. Using previously published cut-off values for liver function, survival data based on the two methods were very similar.
Conclusions Patlak-Rutland analysis gives similar results to Ekman methodology. Due to simpler implementation and use of multiple data points, it may prove to be both an easier and more robust approach. While applicable to current dynamic planar imaging methods, it has the attraction that it can potentially be applied to dynamic SPECT data to generate parametric images of liver uptake rate.
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