Beyond the Liver Function Tests: A Radiologist's Guide to the Liver Blood Tests

Metra, Brandon; Guglielmo, Flavius F.; Halegoua-DeMarzio, Dina; Civan, Jesse; Mitchell, Donald G.

doi:10.1148/rg.210137

Cited by 13 publications

(6 citation statements)

References 62 publications

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“…Blood‐based biomarkers such as the ELF™ (Enhanced Liver Fibrosis) test 4 target hepatic fibrosis and do not measure liver function. Despite their colloquial label as “liver function tests”, ALT and AST indirectly measure hepatocellular injury or inflammation—not liver function 5 . The static measurements of bilirubin, albumin, and prothrombin time/INR detect hepatic dysfunction only in late stages of disease.…”

Section: Introductionmentioning

confidence: 99%

“…Despite their colloquial label as “liver function tests”, ALT and AST indirectly measure hepatocellular injury or inflammation—not liver function. 5 The static measurements of bilirubin, albumin, and prothrombin time/INR detect hepatic dysfunction only in late stages of disease. Each of these markers can be influenced by non‐hepatic factors, and none of them measure hepatic function directly.…”

Section: Introductionmentioning

confidence: 99%

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Within‐individual reproducibility of a dual sample oral cholate challenge test (DuO) and simplified versions of the HepQuant SHUNT test

McRae,

Kittelson,

Helmke

et al. 2024

Clinical Translational Sci

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Current noninvasive liver tests measure fibrosis, inflammation, or steatosis and do not measure function. The HepQuant platform of noninvasive tests uniquely assesses both liver function and physiology through the hepatic uptake of stable isotopes of cholate. However, the prototypical HepQuant SHUNT test (SHUNT V1.0) is cumbersome to administer, requiring intravenous and oral administration of cholate and six peripheral venous blood samples over 90 min. To alleviate the burden of test administration, we explored whether an oral only (DuO) version, and other simplified versions, of the test could provide reproducible measurements of liver function. DuO requires only oral dosing and two blood samples over 60 min. The simplified SHUNT test versions were SHUNT V1.1 (oral and IV dosing but four blood samples) and SHUNT V2.0 (oral and IV dosing but only two blood samples over 60 min). In this paper, we describe the reproducibility of DuO and the simplified SHUNT tests relative to that of SHUNT V1.0; equivalency is described in a separate paper. Data from two studies comprising 236 SHUNT tests in 94 subjects were analyzed retrospectively by each method. All simplified methods were highly reproducible across test parameters with intraclass correlation coefficients >0.93 for test parameters Disease Severity Index (DSI) and Hepatic Reserve. DuO and SHUNT V2.0 improved reproducibility in measuring portal‐systemic shunting (SHUNT%). These simplified tests, particularly DuO and SHUNT V2.0, are easier to administer and less invasive, thus, having the potential to be more widely accepted by care providers administering the test and by patients receiving the test.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Within‐individual reproducibility of a dual sample oral cholate challenge test (DuO) and simplified versions of the HepQuant SHUNT test

McRae,

Kittelson,

Helmke

et al. 2024

Clinical Translational Sci

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“…Abnormal blood test results are often the first sign of liver diseases, such as cirrhosis, and are sometimes used as a guide for PET/CT imaging of the abdomen. Serum indicators, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, and albumin, are commonly used to screen for liver abnormalities [ 9 ]. Moreover, age [ 10 ], blood glucose level [ 11 ], and BMI [ 12 ] have all been shown to affect liver FDG absorption.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, age [ 10 ], blood glucose level [ 11 ], and BMI [ 12 ] have all been shown to affect liver FDG absorption. Abdominal CT is the first imaging modality used when imaging is necessary to examine anomalies [ 9 ]. We searched PubMed using the keywords “Diagnosis of FDG/PET,” “blood test results,” and “Z-score.” No previously published articles related to the objectives of the present study were identified.…”

Section: Introductionmentioning

confidence: 99%

Improved identification of tumors in 18F-FDG-PET examination by normalizing the standard uptake in the liver based on blood test data

Alam,

Hanaoka,

Nomura

et al. 2024

Int J CARS

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Purpose Standardized uptake values (SUVs) derived from 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography are a crucial parameter for identifying tumors or abnormalities in an organ. Moreover, exploring ways to improve the identification of tumors or abnormalities using a statistical measurement tool is important in clinical research. Therefore, we developed a fully automatic method to create a personally normalized Z-score map of the liver SUV. Methods The normalized Z-score map for each patient was created using the SUV mean and standard deviation estimated from blood-test-derived variables, such as alanine aminotransferase and aspartate aminotransferase, as well as other demographic information. This was performed using the least absolute shrinkage and selection operator (LASSO)-based estimation formula. We also used receiver operating characteristic (ROC) to analyze the results of people with and without hepatic tumors and compared them to the ROC curve of normal SUV. Results A total of 7757 people were selected for this study. Of these, 7744 were healthy, while 13 had abnormalities. The area under the ROC curve results indicated that the anomaly detection approach (0.91) outperformed only the maximum SUV (0.89). To build the LASSO regression, sets of covariates, including sex, weight, body mass index, blood glucose level, triglyceride, total cholesterol, γ-glutamyl transpeptidase, total protein, creatinine, insulin, albumin, and cholinesterase, were used to determine the SUV mean, whereas weight was used to determine the SUV standard deviation. Conclusion The Z-score normalizes the mean and standard deviation. It is effective in ROC curve analysis and increases the clarity of the abnormality. This normalization is a key technique for effective measurement of maximum glucose consumption by tumors in the liver.

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“…Magnetic resonance cholangiopancreatography (MRCP) can clearly show the location of obstruction and the number of stones, but it can only provide morphological information of the liver and biliary system, but cannot reflect the functional status of the liver. Because liver dysfunction caused by persistent cholestasis is an important manifestation of obstructive jaundice, the evaluation of liver function in clinical practice is mainly through serum biochemical monitoring [7][8][9]: (1) protein metabolic function monitoring; (2) plasma coagulation factor determination; (3) serum bilirubin determination, which is an important indicator to assess the degree of jaundice; (4) bile acid (BA) metabolism detection, which is synthesized by cholesterol in the liver, and the determination of which can reflect the synthesis, uptake, and secretion function of hepatocytes, and is related to biliary excretion function; (5) liver function test, indocyanine green (ICG) retention test; and (6) detection of serum enzymes and isoenzymes.…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Cholangiopancreatography to Evaluate Improvement Effect of FXR Regulating Bile Acid on Hepatocellular Carcinoma with Obstructive Jaundice

Wang

Liu

2022

Contrast Media & Molecular Imaging

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This research aimed at exploring the improvement effect of Farnesoid X receptor (FXR) regulating bile acid (BA) on hepatocellular carcinoma with obstructive jaundice under magnetic resonance cholangiopancreatography (MRCP). Forty-eight hepatocellular carcinoma patients with obstructive jaundice who were examined in hospital were selected as the study group, and another 10 healthy volunteers who were examined at the same period were selected as the control group. The patients were treated with FXR inhibitor, and the therapeutic effect was observed. The results showed that after treatment, the AST content and TBIL content in serum of the study group were 123.5 ± 4.9 U/L and 1.8 ± 0.3 μmol/L, respectively, which were significantly lower than those before treatment, P < 0.05; the ALT content and AST content in serum in patients with high obstruction were significantly lower than those before treatment, and the K+ content was significantly higher than that before treatment ( P < 0.05). The ALT, AST, and TBIL contents in serum in patients with low obstruction were significantly lower than those before treatment ( P < 0.05). Apparent diffusion coefficient (ADC) was 1.17 ± 0.49 × 10−3 mm2/s in patients with moderate jaundice and 1.20 ± 0.27 × 10−3 mm2/s in patients with severe jaundice, compared with that before treatment, and the difference was statistically significant ( P < 0.05). Based on FXR, it can regulate BA synthesis and metabolism, restore BA metabolic homeostasis, effectively play a hepatoprotective role, reduce bilirubin content in the body, and improve jaundice injury, which has application value.

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Beyond the Liver Function Tests: A Radiologist's Guide to the Liver Blood Tests

Cited by 13 publications

References 62 publications

Within‐individual reproducibility of a dual sample oral cholate challenge test (DuO) and simplified versions of the HepQuant SHUNT test

Within‐individual reproducibility of a dual sample oral cholate challenge test (DuO) and simplified versions of the HepQuant SHUNT test

Improved identification of tumors in 18F-FDG-PET examination by normalizing the standard uptake in the liver based on blood test data

Magnetic Resonance Cholangiopancreatography to Evaluate Improvement Effect of FXR Regulating Bile Acid on Hepatocellular Carcinoma with Obstructive Jaundice

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