8th Baltic Congress of Radiology

08.10.2022  Tallinn, Estonia

Donatas  Jocius (Lithuania)

Presentation

Black Box

Synopsis: Background and aim
Viral hepatitis B and C is the one of leading causes of chronic liver damage resulting liver fibrosis and cirrhosis. Routine work up for viral hepatitis patients includes laboratory testing, medical imaging (ultrasound and magnetic resonance elastography) and liver biopsy, however the latest one is highly questionable “gold” standard. Nuclear medicine imaging is not used as an option determining the degree of liver damage, however there is theoretical potential using hepatobiliary scintigraphy with 99mTc labeled mebrofenin. The aim is to investigate the potential value of hepatobiliary scintigraphy with 99mTc labeled mebrofenin staging chronic liver disease.
Materials and methods
We prospectively enrolled patients with chronic viral hepatitis B and C infection referred for liver biopsy. All patient underwent dynamic liver scintigraphy with 99mTc-mebrofenin prior to liver biopsy. Dynamic liver scintigraphy was performed immediately after intravenous tracer injection for 30 minutes scanning time. Multiple scintigraphy parameters were calculated (whole liver lobe and focal area time to peak (TTP), 30 minutes to peak ratio (30/peak), whole lobe and focal area slope index in 350s (slope_350). Liver biopsy took place shortly after imaging.
Results
Total of 72 HCV (68) and HBV (4) patients were included in the study. Quantitative hepatobiliary scintigraphic parameters were found to be statistically significant differentiating significant and nonsignificant fibrosis (30/peak_dex – p 0,03; focal 30/peak_dex – p 0,016), also separating both advanced fibrosis (e.g. ttp_dex – p 0,007; focal ttp_dex – p 0,025; slope_dex – p 0,0001 etc) and cirrhosis (e.g. ttp_dex – 0,024; 30/peak_dex – 0,000006; slope_dex – p 0,00001 etc).
Conclusions
Dynamic hepatobiliary scintigraphy with 99mTc labeled mebrofenin is good quantitative imaging tool evaluating patients with diffuse liver disease. Moreover, whole liver imaging may give additional information about fibrosis heterogeneity imaging whole liver.

This agenda item is presented in the following session: S5-1 Abdominal Radiology

Plenary session

08.10.2022 09:00 - 10:30