Factors Affecting the Quantitative Liver?Spleen Scan in Normal Individuals

Abstract

The quantitative liver-spleen scan (QLSS) can estimate the functional hepatic mass and the organ volumes by precise measurement of sulfur colloid (SC) distribution. The normal range determined in prior studies was estimated from patients with absence of chronic liver disease in which intense fasting appeared to produce slightly abnormal values. This study was to determine the effect of fasting or fed status and colloid particle size on quantitative measurements from the QLSS in a small cohort of normal individuals. Twelve persons without any medical problems had QLSS taken twice, 2 weeks apart, one fasting and one postprandial. Patients were scanned after injection of 5-6 mCi of SC; six patients were given solution A (5- to 12-microm particle size) and six patients solution B (2- to 12-microm particle size). SPECT and planar analysis were performed. SC distribution of total counts between the liver and the spleen {[L/(L + S)]t ratio}, liver-spleen index (LSI), and liver-bone marrow index (LBI) were calculated. The perfused hepatic mass (PHM) is the average of the LSI and LBI. Spleen and liver volumes are expressed as milliliters per pound ideal body weight (IBW). Results showed that the liver and spleen volumes (solution B postprandial, 9.27 +/- 2.48 and 1.47 +/- 0.57 ml/lb IBW, respectively) and LBI were not affected by the type of SC solution or by ingestion status. L/(L + S) total and pixel count ratios were significantly higher for solution B and postprandial studies. [L/(L + S)]t, LSI, and PHM increased significantly (P < 0.05) from fasting to postprandial for solution A (0.71 +/- 0.13 vs 0.79 +/- 0.08, 80 +/- 14 vs 91 +/- 8, and 102 +/- 10 vs 106 +/- 8, respectively) and for solution B (0.81 +/- 0.05 vs 0.90 +/- 0.02, 86 +/- 4 vs 95 +/- 3, and 101 +/- 5 vs 110 +/- 3). Neither fasting nor postprandial LSI and PHM were significantly different between solution A and solution B. We conclude the following. (1) The QLSS functional indices in "true" normal patients fall within the previously reported normal range. (2) Calculated liver and spleen volumes are not altered by fasting or sulfur colloid particle size. (3) Fasting significantly decreased the [L/(L + S)]t, LSI, and PHM. (4) A postprandial scan may be preferable since the normal values for [L/(L + S)]t, LSI, and PHM are greater, with a narrower range, than fasting values.

Radiation-Induced Liver Disease and Modern Radiotherapy

“…There are some technical challenges to the technique including limited spatial resolution, difficulty with registration to CT, and altered distribution based on particle size. 48 However, these can be overcome to provide meaningful application in radiation planning and evaluation of liver function. 49 Using this approach, investigators demonstrated a 43% reduction in the amount of functional liver volume defined on the 99m Tc-sulfur colloid SPECT-CT as a percentage of predicted liver volume in patients with Child-Pugh Class B cirrhosis.…”

Reference values of mandibular condyles metabolic activity: A study using 99mTc‐MDP single‐photon emission computed tomography

“…Taking into account the technical factors of the SPECT test, including the dose of the radiopharmaceutical, gamma camera calibration and individual factors such as the presence of a bone metabolic disease, renal function, body weight and food intake that may influence the results, [38][39][40] the uptake was measured in a fixed ROI, adding five trans-axial tomographic slides representing the total size of the condyle. This technique reduces intra-operator and inter-operator variability.…”

Functional elements associated with hepatic regeneration in living donors after right hepatic lobectomy

“…The perfused hepatic mass (PHM), which was calculated from these images, was used to quantify the relative distribution of sulfur colloid between the liver, spleen and bone marrow. The liver and spleen volumes were also determined …”

“…The liver and spleen volumes were also calculated from the SPECT reconstruction of images with the Hoefs method . Each volume was derived from the total count in the liver or spleen from regions of interest around the summarized transaxial image and a representative organ concentration from a single transaxial slice through the division of the total hepatic or splenic count by the representative concentration.…”

“…The liver and spleen volumes were also determined. [16][17][18][19][20] The organ volumes and the rates of hepatic regeneration were measured with both CT and SPECT liver-spleen scans.…”