The liver-spleen scan as a quantitative liver function test: Correlation with liver severity at peritoneoscopy

Abstract

Sulfur colloid distribution on liver‐spleen scan is determined by the perfused Kupffer cell mass. The perfused Kupffer cell mass is proportional to the perfused hepatocyte mass, but is less affected by acute changes in hepatocyte function. Thus, sulfur colloid distribution parameters (precisely measured by quantitative liver‐spleen scan [QLSS]) may be an excellent test of the perfused hepatic mass. Although no gold standard exists for confirmation, a close correlation should exist between liver disease severity assessed at peritoneoscopy and sulfur colloid distribution. Peritoneoscopy severity (scored as total peritoneoscopy score [PS]; range, 0–5) was assessed in 76 patients who also had QLSS. Multivariate equation were generated to estimate liver disease severity from the QLSS. These were then applied prospectively in 20 consecutive patients to validate these equations. In 76 patients, 62 were evaluated because of chronic liver disease (CLD) and included those with micronodular (20) and macronodular (20) cirrhosis with various degrees of severity (Child's A, 16; B, 29; C, 17). Multivariate analysis yielded a number of combinations of QLSS parameters that correlated with peritoneoscopic severity. These equations were used to estimate liver disease severity. Estimates of liver disease severity (estimated PS [EPS]) correlated well with the PS in these 76 patients (r = .9064; r2 = .8216; P < .0001). Adding histological fibrosis to the QLSS parameters yields an equation for estimating PS that was even more effective (r = .9462; r2 = .8953; P < .001). However, validation of multivariate equations requires confirmation of their value in a second population. Applying these equations to a prospective group of 20 patients who subsequently had peritoneoscopic evaluation produced a similar correlation for QLSS parameters alone for estimating severity (r = .870; r2 = .757; P < .0001), and this was improved when the equation including histological fibrosis was added (r = .936; r2 = .877; P < .001). We believe these data support the QLSS as a quantitative estimate of the perfused hepatic mass that correlates with liver disease severity at peritoneoscopy. (HEPATOLOGY 1995; 22:1113–1121.).

Spleen size measured on enhanced mri for quantitatively staging liver fibrosis in minipigs

“…Therefore, portal hemodynamics are probably important in the splenomegaly resulting from liver fibrosis. The presence of portal hypertension could be used to explain why some patients with fibrosis had massively enlarged spleens ().…”

“…Third, both liver fibrosis and inflammation might contribute to increased portal pressure, finally resulting in enlargement of the spleen, and we have not differentiated between the two in this study. According to other studies (), the authors evaluated the enlargement of spleen in liver fibrosis and did not take liver inflammation into consideration. Not considering inflammation affecting enlargement of the spleen as in these published articles (), we performed this study initially focusing on using multiple parameters on MRI for measuring the enlargement of spleen to stage liver fibrosis.…”

“…According to other studies (), the authors evaluated the enlargement of spleen in liver fibrosis and did not take liver inflammation into consideration. Not considering inflammation affecting enlargement of the spleen as in these published articles (), we performed this study initially focusing on using multiple parameters on MRI for measuring the enlargement of spleen to stage liver fibrosis. Our future study will focus on how to discriminate between liver fibrosis and inflammation affecting enlargement of the spleen.…”

The use of 99mTc-phytate for assessment the protective effect of vitamin E against hepatotoxicity induced by methotrexat in rat

“…Since 1973, 99m Tc-phytate has been used as an imaging www.journals.viamedica.pl/nuclear_medicine_review Hossein Amirfakhrian et al, Hepatoprotective effect of vitamin E Original radiotracer for liver and spleen assessments. Most of the colloid particles are captured by the Kupffer cells in the liver which is well imaged in nuclear medicine practice [14,15]. Radionuclide distribution in the liver has a great relevance with chronic hepatic disease severity, histological fibrosis severity and hepatic functions.…”

The spectrum of hepatic functional impairment in compensated chronic hepatitis C: results from the Hepatitis C Anti‐viral Long‐term Treatment against Cirrhosis Trial1

“…Simultaneous measurement of clearances of orally and intravenously administered cholate assesses portal‐systemic shunting (cholate shunt) 6 . Hepatic uptake of intravenously administered 99m‐technetium (99Tcm) sulphur colloid, measured by Single Photon Emission liver‐spleen scan (SPECT‐LSS), defines perfused hepatic mass (PHM) 7, 8 …”