• The Korean Journal of Nuclear Medicine
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• v.32 no.4
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• pp.305-313
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• 1998

The reduction in the amount of asialoglycoprotein (ASGP) receptor, which resides exclusively on the plasma membrane of functioning mammalian hepatocytes, as a consequence of hepato-cellular damage has been demonstrated in various pathologic conditions of the liver. Galac-tosylated human serum albumin (GSA) is a newly developed receptor-binding agent, specific for the ASGP receptor. Tc-99m GSA binds quantitatively to liver ASGP receptors and the rate of accumulation in the liver is dependent on hepatic function represented as the amount of receptor, as well as the amount of ligand injected, its affinity to the receptor and the hepatic blood flow. The findings of Tc-99m GSA scintigraphy were reported to reflect the hepatic function of the patients with large hepatic tumors, obstructive jaundice, acute and chronic liver disease. Tc-99m GSA scintigraphy is an easy and reliable test and has the clinical potentials to evaluate the liver function in the patients with hepatic disorders.

• The Korean Journal of Nuclear Medicine
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• v.21 no.1
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• pp.25-32
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• 1987

Authors analysed biochemical studies and scintigraphic findings of obstructive jaundice and nonobstructive jaundice in 44 cases of $^{99m}Tc-DISIDA$ scintigraphy with nonvisualization of biliary excretion till 120 min or 240 min after injection of $^{99m}Tc-DISIDA$. Causative diseases of $^{99m}Tc-DISIDA$ scintigraphy with nonvisualization of biliary excretion were in order to choledocholithiasis (25%), hepatitis (25%), cholangiocarcinoma (14%), cholangitis (14%) and pancreas head tumor (11%). In obstructive jaundice, statistically significant findings were elevated alkaline phosphatase above 300 IU/L on biochemical study and single lobe enlargement of the liver, irregular radioisotope uptake of the liver and concave indentation of the gall bladder fossa of the liver on scintigraphy. In nonobstructive jaundice, statistically significant findings were persistent renal excretion of $^{99m}Tc-DISIDA$ and more increased uptake density of the heart than the liver on scintigraphy.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.76-80
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• 1991

To evaluate the prognostic significance of $^{99m}Tc-phytate$ liver scintigraphy in patients with cirrhosis, we measured the grade of extrahepatic uptake (EHU) of $^{99m}Tc-phytate$, from 0 (absent EHU) to 5 (important EHU), according to the relative distribution of the radiotracer among liver, spleen and bone marrow. The results were as follows: 1) EHU score was correlated to the Pugh score (r=0.64) and to survival. 2) The ROC curve on an observed status of death was superior for EHU score. In conclusion, $^{99m}Tc-phytate$ liver scintigraphy nay be a useful prognostic method in patients with liver cirrhosis.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.388-397
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• 1999

Purpose: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Perrectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. Materials and Methods: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Perrectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. Results: The shunt index in 40 patients with cirrhosis ($59.8{\pm}27.2%$) was significantly higher than that of normal control ($5.0{\pm}1.2%$. p<0.01) and chronic hepatitis ($11.4{\pm}3.5%$, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from $59.9{\pm}27.3%$ to $51.3{\pm}15.3%$ (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. Conclusion : The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.

• Korean Journal of Veterinary Research
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• v.39 no.2
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• pp.390-393
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• 1999

Transcolonic scintigraphy using $^{99m}Technetium$ pertechnetate ($^{99m}TcO_{4}$) was performed in 5 dogs with portosystemic shunts. In all dogs, the activity in the heart was seen before liver activity. Also time activity curve was revered. The mean shunt index in 5 dogs was 82.3% (range 79.6~87.1%). Transcolonic scintigraphy is quick, simple and useful diagnostic method for canine portosysternic shunts.

• The Korean Journal of Nuclear Medicine
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• v.36 no.3
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• pp.185-194
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• 2002

Purpose: We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Materials and Methods: Forty-nine patients with pulmonary radioactivity were classified into 5 disease groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence or absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Results: Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Conclusion: Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver destruction in liver diseases.

• 대한핵의학회:학술대회논문집
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• 1973.11a
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• pp.49.2-49.2
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• 1973

• The Korean Journal of Nuclear Medicine
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• v.20 no.1
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• pp.33-37
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• 1986

It is well known that $^{99m}Tc-sulfur$ colloid or phytate hepatic scintigraphy is highly sensitive but not specific. Both $^{99m}Tc-DISIDA$ and bilirubin have been shown to share the same anionic transport pathway in the liver. Hepatocellular carcinoma(HCC) retains the ability to produce bile but has marked limitation to excreting it resulting in accumulation of bile within the tumor cells. Based upon such a fact, $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy is used for the diagnosis of HCC. The present communication deals with our experience of DISIDA scintigraphic exploration of 9 cases of HCC in a retrospective way. We have made an observation on intensity of positive radio nuclide accumulation in the cold area of HCC as it is demonstrated by phytate scintigraphy. In addition we have semi quantitatively analyzed time-activity pattern and the following results were obtained. (1) All of 9 cases showed an increased uptake of $^{99m}Tc-DISIDA$ in delayed scintigrams. Of these 5 cases showed accumulation less than, 3 equal to, 1 more than the surrounding liver tissue. (2) The mean of the first appearing time of $^{99m}Tc-DISIDA$ activity in tumoral region was 2 hours and 20 minutes. (3) DISIDA scintigraphy provides us with positive informations of diagnostic value.

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.189-193
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• 1989

To observe the effect of gastric filling on the images of hepatic scintigraphy, we performed hepatic scintigraphy using $^{99m}Tc-tin$ colloid in twenty patients both in the fasting state and after meal, and made the visual comparison of both images. We found that gastric filling could cause some of the following changes in individual patients. 1) In the anterior view, the distance between the liver and the spleen increased and the interlobar notch of the inferior hepatic border was obliterated. The spleen was displaced downwards, its radioactivity in the upper medial part was reduced, and its upper pole was laterally displaced. 2) In the posterior view, the left lobe of the liver was separated from the spleen and the distance between the liver and the spleen increased. 3) In the right lateral view, the notch separating the right and the left lobes of the liver was well demarcated. 4) In the left lateral view, the spleen was separated from the liver and the distance between the liver and the spleen increased. The shape of the spleen was also changed. In case of the follow-up study, above changes should make one consider the possibility of the effect of gastric filling.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.49-56
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• 1999

Purpose: Heart to liver ratio on T1-201 per rectal scintigraphy (shunt index) is known to be useful in the assessment of portal systemic shunt. We assessed T1-201 uptake pattern and early liver/heart uptake rate of T1-201 and correlated with shunt index in patients with chronic active hepatitis (CAH) and liver cirrhosis (LC). Materials and Methods: Fifty eight patients with biopsy-proven chronic liver disease (35 with CAH, 23 with LC) underwent T1-201 per rectum scintigraphy after instillation of 18.5 MBq of T1-201 into the upper rectum. We evaluated hepatic uptake (type 1 : homogeneous, 2: inhomogeneous segmental, 3: inhomogeneous nonsegmental) and extrahepatic uptake of spleen, heart and kidney (grade 0: no uptake, 1: less than liver, 2: equal to liver, 3: greater than liver). We measured the early liver/heart uptake rate (the slope of the liver to heart uptake ratio for 10 min) and shunt index (heart to liver uptake ratio). T1-201 uptake pattern and early liver/heart uptake rate of T1-201 was correlated with the pathologic diagnosis and shunt index. Results: Hepatic uptake patterns of type 1 and 2 were dominant in CAH (CAH: 27/35, LC. 8/23), and type 3 in LC (CAH: 8/35, LC: 15/23)(p<0.005). The grades of extrahepatic uptake were higher in LC than in CAH (spleen: p<0.001, other soft tissue: p<0.005). The early liver/heart uptake rate of CAH ($0.110{\pm}0.111$) was significantly higher than that of LC ($0.014{\pm}0.090$)(p<0.001). The sensitivity and specificity of the early liver/heart uptake rate were 77.7% and 67.7% in differentiating LC from CAH. There was negative correlation between early liver/heart uptake rate and shunt index (r=-0.3347, p<0.01). Conclusion: Hepatic and extrahepatic uptake pattern and early liver/heart uptake rate on T1-201 per rectum scintigraphy are useful in the assessment of portal systemic shunt in patients with chronic liver disease.