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 $T\frac{1}{2}$ 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 T½ and maximal hepatic uptake between the diabetic and control population groups. The $T1/2$ ascend was prolonged in T2DM ( $(70.9\pm13.8$ Vs. $54.2\pm14.3$ seconds, $p<0.0001$ suggesting slower rate of uptake and the hepatic uptake was also decreased $(76.9\pm5.5\%$ Vs. $85.5\pm2.6\%$ $p<0.0001)$. There is also significant difference among T2DM subgroups with $BMI<25$ $(n=11)$ and> 25 $(n=18)$ in T½ (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.