Different concentrations of various radiopharmaceuticals in the two main liver lobes: a preliminary study in clinical patients

• Published in: Journal of gastroenterology Vol. 40; no. 7; pp. 733 - 738
• Main Authors: Jacobsson, Hans, Jonas, Eduard, Hellström, Per M, Larsson, Stig A
• Format: Journal Article
• Language: English
• Published: Japan Springer Nature B.V 01.07.2005
• Subjects: 3-Iodobenzylguanidine - pharmacokinetics; Adult; Age Factors; Case-Control Studies; Dose-Response Relationship, Drug; Female; Humans; Liver Diseases - diagnostic imaging; Liver Diseases - pathology; Male; Medicin och hälsovetenskap; Middle Aged; Probability; Radiopharmaceuticals - pharmacokinetics; Reference Values; Retrospective Studies; Sensitivity and Specificity; Sex Factors; Time Factors; Tissue Distribution; Tomography, Emission-Computed, Single-Photon - methods
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-005-1617-9

At clinical scintigraphic examinations of the abdomen using single photon emission computed tomography (SPECT), we have observed a different distribution between the left and right main liver lobes of various radiopharmaceuticals. This was studied retrospectively in clinical patients. Examinations with [123I]-metaiodobenzylguanidine MIBG; (n=19), a 99mTc-labelled monoclonal antibody against granulocytes (n=18), and 111In-pentetreotide (n=26) were assessed. There was no known history of, or risk factor for liver disease, and all lobes showed a uniform activity distribution. Twenty healthy volunteers underwent consecutive examinations with 99mTc-dimethyliminodiacetic acid (HIDA). The activity ratios between the left and right main liver lobes were calculated from the transverse tomographic (SPECT) sections. The left: right lobar activity ratio for [123I]-MIBG was (mean+/-SD) 1.25+/-0.21 (null hypothesis=1.00; P<0.001); for the antibody, acquisition after 3-5 h was 0.98+/-0.06 (NS) and after 20-24 h, 0.99+/-0.11 (NS); for 111In-pentetreotide, 0.90+/-0.09 (P<0.001); for 99mTc-HIDA, immediate acquisition, 0.68+/-0.12 (P<0.001) and acquisition at 7 min, 0.66+/-0.12 (P<0.001). The differences in tracer uptake between the liver lobes cannot be caused only by differences in blood flow. One explanation of the higher uptake of [123I]-MIBG by the left lobe may be a greater presence of catecholamines and a higher sympathetic nerve density in this liver portion. Consequently, there may be a functional difference between the two main liver lobes.