Quantitation of liver and spleen uptake of (99m)Tc-phytate colloid using SPECT: detection of liver cirrhosis.

UNLABELLED: The purpose of this study was to assess the diagnostic performance of quantitative SPECT of (99m)Tc-phytate colloid in detecting liver cirrhosis and to assess the correlation between the SPECT results and the severity of disease.
METHODS: Quantitative SPECT was performed on 60 patients (38 men, 22 women; mean age, 62.4 y) with liver cirrhosis and 36 control patients (21 men, 15 women; mean age, 58.7 y) without liver cirrhosis, and the results for the 2 groups were compared. Correlation with Child--Pugh classification and receiver operating characteristic methodology was used to analyze the results.
RESULTS: Cirrhotic livers had a lower total uptake than did control livers (35.6% plus minus 13.5% vs. 61.6% +/- 10.2%, P < 0.0001). This reduced uptake was associated with a significantly reduced percentage injected dose per cubic centimeter (%ID/cm(3)) (0.024 +/- 0.01 vs. 0.044 +/- 0.01, P < 0.0001). The volume, 1,467 +/- 348 cm(3), was similar to that of control livers (1,487 +/- 397 cm(3), P = 0.80). Total uptake in the spleen was significantly greater in patients with cirrhosis than in control patients (24.9% +/- 12% vs. 7.6% +/- 3.2%, P < 0.0001) because of an increased volume (833 +/- 460 cm(3) vs. 239 +/- 90 cm(3), P < 0.0001). The %ID/cm(3) of spleen tissue was 0.033 +/- 0.01, which was similar to the value in control patients (0.032 +/- 0.01, P = 0.88). Spleen volume showed the best performance in detecting liver cirrhosis, with a mean area under the curve of 0.97 (95% CI = 0.91--0.99). The severity of liver disease correlated better with total liver uptake (r = -0.68, 95% CI = -0.80 to -0.52, P < 0.0001).
CONCLUSION: Individual SPECT quantitation of (99m)Tc-phytate colloid uptake in the liver and spleen could be used as a noninvasive method to separate normal from cirrhotic livers and to evaluate the severity of disease.