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. 2017 Aug 29;7(1):71.
doi: 10.1186/s13550-017-0320-1.

Metabolic liver function in humans measured by 2-18F-fluoro-2-deoxy-D-galactose PET/CT-reproducibility and clinical potential

Kirstine P Bak-Fredslund  1   2 , Peter Lykke Eriksen  2 , Ole L Munk  1 , Gerda E Villadsen  2 , Susanne Keiding  1   2 , Michael Sørensen  3   4
Affiliations

Metabolic liver function in humans measured by 2-18F-fluoro-2-deoxy-D-galactose PET/CT-reproducibility and clinical potential

Kirstine P Bak-Fredslund et al. EJNMMI Res. .

Abstract

Background: PET/CT with the radioactively labelled galactose analogue 2-18F-fluoro-2-deoxy-D-galactose (18F-FDGal) can be used to quantify the hepatic metabolic function and visualise regional metabolic heterogeneity. We determined the day-to-day variation in humans with and without liver disease. Furthermore, we examined whether the standardised uptake value (SUV) of 18F-FDGal from static scans can substitute the hepatic systemic clearance of 18F-FDGal (K met, mL blood/min/mL liver tissue/) quantified from dynamic scans as measure of metabolic function. Four patients with cirrhosis and six healthy subjects underwent two 18F-FDGal PET/CT scans within a median interval of 15 days for determination of day-to-day variation. The correlation between K met and SUV was examined using scan data and measured arterial blood concentrations of 18F-FDGal (blood samples) from 14 subjects from previous studies. Regional and whole-liver values of K met and SUV along with total metabolic liver volume and total metabolic liver function (total SUV, average SUV multiplied by total metabolic liver volume) were calculated.

Results: No significant day-to-day differences were found for K met or SUV. SUV had higher intraclass correlation coefficients than K met (0.92-0.97 vs. 0.49-0.78). The relationship between K met and SUV was linear. Total metabolic liver volume had non-significant day-to-day variation (median difference 50 mL liver tissue; P = 0.6). Mean total SUV in healthy subjects was 23,840 (95% CI, 21,609; 26,070), significantly higher than in the patients (P < 0.001).

Conclusions: The reproducibility of 18F-FDGal PET/CT was good and SUV can substitute K met for quantification of hepatic metabolic function. Total SUV of 18F-FDGal is a promising tool for quantification of metabolic liver function in pre-treatment evaluation of individual patients.

Keywords: Galactose; Metabolic liver function; Molecular imaging; Positron emission tomography; Remnant liver function.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures were in accordance with the ethical standards of the national research committee and with the principles of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent for publication

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Correlations between K met and SUV of 18F-FDGal for paired measurements in patients with cirrhosis (black circle) and healthy subjects (white circle). Regional VOI values (a, c) and whole-liver VOI values (b, d) for the reconstruction algorithm with resolution modelling and a 168 matrix are shown with lines of identity
Fig. 2
Fig. 2
Correlations between regional values of SUV and K met (a) and between whole-liver values of SUV and K met (b) for 18F-FDGal PET/CT in patients with cirrhosis (black circle) and healthy subjects (white circle). Results from reconstruction algorithm with resolution modelling and a 168 matrix are shown with fitted linear regression lines
Fig. 3
Fig. 3
Paired measurements of total functional liver volume in patients with cirrhosis (black circle) and healthy subjects (white circle) with line of identity
Fig. 4
Fig. 4
Effect on remnant functional liver volume and total SUV of 18F-FDGal by simulated resections of 30% of total functional liver volume in two patients with cirrhosis. The effect is calculated in percentage of baseline values
See this image and copyright information in PMC

References

    1. European Association for the Study of Liver EASL-ALEH Clinical Practice Guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63:237–264. doi: 10.1016/j.jhep.2015.04.006. - DOI - PubMed
    1. de Graaf W, van Lienden KP, van Gulik TM, Bennink RJ. 99mTC-mebobrofenin hepatobiliary scintigraphy with SPECT for the assessment of hepatic function and liver functional volume before partial hepatectomy. J Nucl Med. 2010;51:229–236. doi: 10.2967/jnumed.109.069724. - DOI - PubMed
    1. Nilsson H, Blomqvist L, Douglas L, Nordell A, Janczewska I, Näslund E, Jonas E. Gd-EOB-DTPA-enhanced MRI for the assessment of liver function and volume in liver cirrhosis. Br J Radiol. 2013;86:20120653. doi: 10.1259/bjr.20120653. - DOI - PMC - PubMed
    1. Sørensen M, Mikkelsen KS, Frisch K, Villadsen GE, Keiding S. Regional metabolic liver function measured in patients with cirrhosis by 2-[18F]fluoro-2-deoxy-D-galactose PET/CT. J Hepatol. 2013;58:1119–1124. doi: 10.1016/j.jhep.2013.01.012. - DOI - PMC - PubMed
    1. Cieslak KP, Bennink RJ, de Graaf W, van Lienden KP, Besselink MG, Busch OR, Gouma DJ, van Gulik TM. Measurement of liver function using hepatobiliary scientigraphy improves risk assessment in patients undergoing major liver resection. HPB. 2016;18:773–780. doi: 10.1016/j.hpb.2016.06.006. - DOI - PMC - PubMed

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