Browse > Article

$^{99m}Tc-DTPA$ Galactosyl Human Serum Albumin Scintigyaphy in Mushiroom Poisoning Patient : Comparison with Liver Ultrasonography  

Jeong, Shin-Young (Department of Nuclear Medicine, Kyungpook National University School of Medicine)
Lee, Jea-Tae (Department of Nuclear Medicine, Kyungpook National University School of Medicine)
Bae, Jin-Ho (Department of Nuclear Medicine, Kyungpook National University School of Medicine)
Chun, Kyung-Ah (Department of Nuclear Medicine, Kyungpook National University School of Medicine)
Ahn, Byeong-Cheol (Department of Nuclear Medicine, Kyungpook National University School of Medicine)
Kang, Young-Mo (Department of Internal Medicine, Kyungpook National University School of Medicine)
Jeong, Jae-Min (Department of Nuclear Medicine, Seoul University Hospital)
Lee, Kyu-Bo (Department of Nuclear Medicine, Kyungpook National University School of Medicine)
Publication Information
The Korean Journal of Nuclear Medicine / v.37, no.4, 2003 , pp. 254-259 More about this Journal
Abstract
$^{99m}Tc-galactosyl$ human serum albumin (Tc-GSA) is a radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically present in the hepatocyte membrane. Because these receptors are decreased in hepatic parenchymal damage, the degree of Tc-GSA accumulation in the liver correlates with findings of liver function test. Hepatic images were performed with Tc-GSA in patients with acute hepatic dysfunction by Amantia Subjunquillea poisoning, and compared with these of liver ultrasonography (USG). Tc-GSA (185 MBq, 3 mg of GSA) was injected intravenously, and dynamic images were recorded for 30 minutes. Time-activity curves for the heart and liver were generated from regions of interest for the whole liver and precordium. Degree of hepatic uptake and clearance rate of Tc-GSA were generated by visual interpretation and semiquantitative analysis parameters (receptor index : LHL15 and index of blood clearance : HH15). Visual assessment of GSA scintigraphy revealed mildly decreased liver uptake in all of subjects. The mean LHL15 and HH15 were 0.886 and 0.621, graded as mild dysfunction in 2, and mild to moderate dysfunction in 1 subject. In contrast, liver USG showed no remarkable changes of hepatic parenchyme. Tc-GSA scintigraphy was considered as a useful imaging modality in the assessment of the hepatic dysfunction.
Keywords
$^{99m}Tc-DTPA$ galactosyl human serum albumin; liver ultrasonography; Amanita subjunquillea poisoning; liver function;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Mitchel DH. Amanita mushiroom poisoning. Am Rev Med 1980;31:51-7
2 Imaeda T, Kanematsu M, Asada S, Seki M, Doi H, Saji S, et al. Utility of Tc-99m GSA SPECT imaging in estimation of functional volume of liver segments in health and liver disease. Clin Nucl Med 1995;20:322-8
3 Sawanura T, Nakada H, Hazama Y, Shiozaki Y, Sameshima Y, Tashiro Y. Hypersialoglycoproteinemia in patients with chronic liver diseaorses and/ liver cell carcinoma. Gastoenterol 1984;87:1217-21
4 Sueyoshi K, Narabayashi I, Aratani T, Doi K, Komori T, Ogura Y, et al. Utility of Tc-99m GSA whole-body scintigraphy in detection bone metastasis from hepatocelluar carcinoma. Clin Nucl Med 2001;26:221-4
5 Sakahara H, Kiuchi T, Nishizawa S, Saga T, Nakamoto Y, Sato N, et al. Asialoglycoprotein receptor scintigraphy in evaluation of auxiliary partial orthotopic liver transplantation. J Nucl Med 1999;40:1463-7
6 Hwang EH, Taki J, Shuke N, Nakajima S, Kinuya S, Konishi S, et al. xreoperative assessment of residual hepatic functional reserve using $^99m$Tc-DTPA-galactosyl-human serum albumin dynamic SPECT. J Nucl Med 1999;40:1644-51
7 Tomiguchi S, Kira T, Oyama Y, Nabeshima M, Nakashima R, Tsuji A, et al. Correlation of Tc-99m GSA hepatic studies with biopsies in patients with chronic active hepatitis. Clin Nucl Med 1995;20:717-20
8 Gore JC. Textbook of gastrointestinal radiology 2nd ed.:Saunders;2000. p.1588
9 Chalfin L. Beware the wild mushroom. Emergency medicine 1985;17:76
10 Sasaki N, Shiomi S, Iwata Y, Nishiguchi S, Kuroki T, Kawabe J, et al. Clinical usefulness of scintigraphy with $^99m$Tc-galactosyl-human serum albumin for prognosis of cirrhosis of the liver. J Nucl Med 1999;40:1652-6
11 Kubota Y, Kitagawa S, Inoue K, Ha-Kawa SK, Kojima M, Tanaka Y. Hepatic functional scintigraphic imaging with 99mTechnetium galactosyl serum albumin. Hepato-gastroenterol 1993;40:32-6
12 Shiomi S, Kuroki T, Enomoto M, Ueda T, Masaki K, Ikeoka N, et al. Fulminant hepatic failure monitored by technetium-99m-DTPA-galactosyl-human serum albumin scintigraphy. J Nucl Med 1996;37:641-3
13 Miki K, Kubota K. Inoue Y, Vera DR, Makuuchi M. Receptor mearsurements via Tc-GSA kinetic modeling are proportional to functional hepatocelluar mass. J Nucl Med 2001;42:733-37
14 Sawanura T, Nakada H, Hazama Y, Shiozaki Y, Sameshima Y, Tashiro Y. Hypersialoglycoproteinemia in patients with chronic liver diseaorses and/ liver cell carcinoma. Gastoenterol 1984;87:1217-21
15 Shiomi S, Kuroki T, Kuriyama M, Takeda T, Nishiguchi S, Nakajima S, et al. Evaluation of fulminant hepatic failure by scintigraphy with technetium-99m-GSA. J Nucl Med 1997;38:79-82
16 Ha-Kawa SK, Tanaka Y, Hasebe S, Kuniyasu Y, Koizumi K, Ishii Y, et al. Compartmental analysis of asialoglycoprotein receptor scintigraphy for quantitative measurement of liver function:a multicentre study. Eur J Nucl Med 1997;24:130-7
17 Kudo M, Todo A, Ikekubo K, Hino M. Receptor index via hepatic asialoglycoprotein receptor imaging:Correlation with chronic hepatocellular damage. Am J Gastroenterol 1992;87:865-70
18 Ha-Kawa SK, Suga Y, Ikeda K, Nagata K, Murata T, Tanaka Y. Usefulness of blood disappearance corrected hepatic uptake ratio (LHL/HH) as a hepatic functional index using $^99m$Tc-galactosyl serum albumin. Jpn J Nucl Med 1993;30:1333-9
19 Lee KH, Lee JW, Min BC, Choi SO, Jang WI, Kim YS, et al. The 16 cases of Fatal Mushiroom poisoning on 1987 in Young-Seo Region. Kor J Int Med 1990;38:58-67
20 Rho H, Kim J, Kang H, Lee M, Hyun S, Kang Y, et al. Clinical manifestations of amanita subjunquillea poisoning. Kor J Med 2000;58:453-61
21 Pimostone NR, Standalnik RC, Vera DR, Hutak DP, Trudeau WL. Evaluation of hepatocelluar function by way of receptor-mediated uptake of a technetium-99m-labeled asialoglycopretein analog. Hepatol 1994;20:917-23
22 Litten W. The most poisonous mushiroom. Sci Am 1975;232:90-101