TC-99M NGA IN THE EVALUATION OF LIVER DISEASE

我们建议继续前瞻性地比较Tc-NGA 用定量功能测定法估计肝功能 从14 C-氨基比林呼气试验（ABT）获得的值，以确定 肝脏疾病的严重程度。 ABT测试被发现有助于评估 肝功能，并提供了一个简单的程序，定量 评估微粒体和肝细胞功能的人。该测试是更多 检测肝细胞疾病的灵敏度高于标准肝功能 试验. ABT易于执行，是非侵入性的，将作为一个 补充其他肝功能检查。 ABT评分是可靠的 病毒性肝炎、重型肝炎和重型肝炎的组织学肝损伤的测量 任何原因，药物或病毒引起的坏死，以及酒精性肝病。 它 也与这些疾病的组织病理学改善密切相关。 基于HBP浓度的估计，Tc-NGA功能性肝成像 应该是特别重要的预后疾病， 坏死、慢性肝炎和肝移植候选者。 它 可以在评估主要的医疗或手术治疗中发挥作用， 皮质类固醇治疗和门体分流。 我们计划检查 Tc-NGA作为定量肝功能试验在三个 领域：1）确定预后，2）评估医疗和 手术治疗; 3）肝血流量。 所有患者将进行血清样本的内源性配体测定。 许多研究人员报告说， 肝病患者的去唾液酸糖蛋白。 然而，这些价值观， 比我们对正常受体的估计低两个数量级 浓度. 严重的肝硬化可能会抑制[R]， 配体可能会影响我们的受体估计。 将比较这些值 从动力学分析获得的受体估计值。 虽然我们 验证（见进度报告）体内受体估计，使用 健康猪，人体体外和体内测量的相关性 疾病将显着有助于验证Tc-NGA作为一种 用于体内生物化学的功能成像剂。 如果可能的话，我们会 还检索和测定肝活检样品的HBP浓度。

We propose to continue to prospectively obtain comparisons of Tc-NGA estimates of hepatic functional capacity with quantitative functional values obtained from the 14C-aminopyrine breath test (ABT) to define the severity of liver disease. The ABT test has been found useful to assess liver function and provide a simple procedure for the quantitative assessment of microsomal and hepatocyte function in man. The test is more sensitive in detecting hepatocellular disease than standard liver function tests. The ABT is easy to perform, is non-invasive and will serve as a complement to other liver function tests. The ABT score is a reliable measure of histologic liver damage in viral hepatitis, severe hepatic necrosis from any cause, drug or viral, and in alcoholic liver disease. It also correlates well with histopathologic improvement in those conditions. Based on estimates of HBP concentration, Tc-NGA functional liver imaging should be of particular prognostic importance in diseases such as hepatic necrosis, chronic hepatitis and candidates for liver transplantation. It may serve a role in evaluating major medical or surgical therapies such as corticosteroid treatment and portal systemic shunting. We plan to examine the usefulness of Tc-NGA as a quantitative liver function test in three areas: 1) Determination of prognosis, 2) Evaluation of medical and surgical therapies, 3) Liver blood flow. All patients will have endogenous ligand assay from a serum sample. Various investigators have reported increased levels of circulating asialoglycoprotein in patients with liver disease. These values, however, are two orders of magnitude below our estimates of normal receptor concentration. Severe cirrhosis may depress [R] such that endogenous ligand may influence our receptor estimates. These values will be compared to the receptor estimates obtained from kinetic analysis. Although we have validated (see Progress Report) the in vivo receptor estimates using healthy pigs, correlation of in vitro and in vivo measurements in human disease will significantly contribute to the validation of Tc-NGA as a functional imaging agent for in vivo biochemistry. When possible we will also retrieve and assay liver biopsy samples for HBP concentration.