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Radiopharmaceuticals for Diagnostics
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Jim Ballinger, Jacek Koziorowski
Hepatobiliary scintigraphy is performed with a lipophilic compound that is taken up by the liver, then rapidly clears through the gall bladder and is excreted into the small intestine. The most widely used tracer is 99mTc-mebrofenin (bromo-2,4,6-trimethylacetanilido iminodiacetic acid, BrIDA, Cholecis, Choletec, Cholediam), though 99mTc-disofenin (2,6-diisopropylacetanilido iminodiacetic acid, DISIDA, Hepatolite) is still used in some countries. These agents can be considered the first bifunctional chelators, that is, constructs designed to contain both a biological targeting group and a chelator for 99mTc.
Biliary Atresia
Published in Gianfranco Alpini, Domenico Alvaro, Marco Marzioni, Gene LeSage, Nicholas LaRusso, The Pathophysiology of Biliary Epithelia, 2020
Recently, we examined the etiology of jaundice in the inv mouse to determine if this mouse also had an interruption of the extrahepatic biliary tree and whether it represented an animal model of BA associated with situs inversus.109 The results show that these mice have cholestasis with conjugated hyperbilirubinemia, failure to excrete technetium-labeled mebrofenin from the liver into the small intestine (Fig. 2), lack of continuity between the extrahepatic biliary tree and the small intestine as demonstrated by Trypan blue cholangiography, and a liver histological picture indicative of extrahepatic biliary obstruction with negligible inflammation/necrosis within the hepatic parenchyma. Lectin histochemical staining of biliary epithelial cells in serial sections suggests the presence of several difierent anomalies in the architecture of the extrahepatic biliary system. These results suggest that the inversin gene plays an essential role in the morphogenesis of the hepatobiliary system and raise the possibility that alterations in the human orthologue of inversin account for some of the cases of BA in which there are also anomalies of situs determination. Indeed, liver is one of the predominant sites of inversin gene expression, beginning very early in embryonic development.99,100
Paediatrics
Published in Vincent Helyar, Aidan Shaw, The Final FRCR, 2017
Phenobarbital is given for 5 days prior to imaging to stimulate biliary secretion.Tracers used: technetium-99m, diosgenin or mebrofenin.Biliary excretion by 60 minutes is normal.Biliary atresia diagnosed if no tracer is seen in the bowel at 24 hours (hepatic uptake is normal). Also demonstrates delayed clearance from the cardiac pool and increased renal excretion and bladder activity.Neonatal hepatitis is indicated by a delayed/reduced hepatic uptake.
Alpha-ketoglutarate mediated hepatoprotection against alcohol induced toxicity: in vivo functional observation studies in Sprague Dawley rats using gamma scintigraphy
Published in Drug and Chemical Toxicology, 2020
Lalita Mehra, Harish Rawat, Abhinav Jaimini, Amit Tyagi, Gaurav Mittal
Present study elucidates the hepatoprotective potential of alpha-ketoglutarate against alcohol-induced toxicity by estimating its effect on the levels of transaminases, enzymatic antioxidants (catalase, superoxide dismutase, and total reduced glutathione) and lipid peroxidation. Histological assessment between different treatment groups was also done. Besides these conventional markers, another important highlight of the study is the use of hepatobiliary scintigraphy (HBS) in establishing the hypothesis in vivo. This real time functional imaging study was done under a gamma camera using 99mTc-mebrofenin as radiotracer. We determined (a) Hepatic extraction fraction (HEF), for quantification of radiotracer uptake, thereby signifying viable parenchymal liver cell mass, (b) Time to reach maximum hepatic uptake (Tpeak), and (c) Time for hepatic uptake to reduce by 50% (T1/2 peak), for quantification of radiotracer excretion from the liver cells.