Étude de la variabilité de la clairance hépatique de la mébrofénine-99mTc en scintigraphie hépatobiliaire

Abstract

AimThe purpose of this study was to investigate some of the parameters likely to influence mebrofenin-99mTc hepatic clearance calculation and inter-and intra-observers reproducibility. Materials and methodsHepatic clearance (%/minm2) of 30 scintigraphies was calculated from the values of hepatic, cardiac, and total activities, according to the method recommended in the literature. We studied: 1) impact of injection–acquisition delay variations; 2) acquisition type: anterior face only (FA) or geometric mean (GM); 3) clearances calculated according to four different body surface area (BSA) formulas; 4) intra-and inter-observers reproducibility for three observers (two evaluations for each observer). Results1) Clearance differences between different studied intervals were statistically significant, more important if the studied interval was far from reference interval (150–350secondes) and even more when the interval studied was too early (110–310secondes). 2) There was a statistically significant difference between clearance calculated using either FA or GM datasets (0.85 %/minm2). 3) There were small but statistically significant differences for four of the clearance comparisons using different BSA formulas. 4) Despite differences in size of cardiac and hepatic regions of interest (ROI), intra-observer reproducibility of hepatic clearance was excellent for each observer. Inter-observers reproducibility was also excellent (r=0.982). ConclusionHepatic clearance of mebrofenin-99mTc appears to be a highly reproducible method provided that acquisition and clearance calculation are standardized. It provides additionnal functional information to morphological and biological data usually performed before major hepatectomy. Thereby, the definition of a standardized protocol would enable realization of multicentric studies.