HIDA Scintigraphy Diagnoses Early Hepatic Dysfunction in Diabetic Population
Abstract
Introduction: Mebrofenin scintigraphy estimates hepatocellular function because of its high hepatic specificity and is correlated with histopathological severity in NAFLD.
Objective: The aim of this case control pilot study was to evaluate hepatobiliary function by 99mTc-mebrofenin scintigraphy in Type 2 diabetes.
Methods: 29 T2DM patients (with a minimum of 2 years duration of DM) and 20 BMI matched volunteers were injected with 185 MBq 99mTc- Mebrofenin intravenously. The liver function tests and viral serology of all patients and volunteers were within normal limits. Hepatic radiotracer activity accumulation rate was estimated as the T ½ of its ascending portion of the Time activity curve and maximal accumulation as percentage of total activity (FOV curve).
Results: There was a significant difference in ascending T ½ and maximal hepatic uptake between the diabetic and control population groups. The T1/2 ascend was prolonged in T2DM (70.9± 13.8 Vs. 54.2± 14.3 seconds, p<0.0001) suggesting slower rate of uptake and the hepatic uptake was also decreased (76.9± 5.5% Vs. 85.5± 2.6% p<0.0001). There is also significant difference among T2DM subgroups with BMI < 25 (n=11) and > 25 (n=18) in T ½ (64.6 vs 74.7 p =0.04) and uptake percentage (79.1%vs 75.6% p=0.04).
Conclusions: Although liver biopsy remains the gold standard for diagnosis, our pilot results suggest nuclear medicine imaging with 99mTc-mebrofenin is a useful tool in the investigation of NAFLD in T2DM.
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