Quantitative Liver Function
Liver function can be reduced by infections, alcohol and fat buildup. HEPATIQ is the first automated software to precisely provide quantitative liver function using nuclear medicine. Other tests on the market estimate the extent of fibrosis (or scarring) in the liver and do not quantitate liver function.
Function Determines Outcomes
The liver can generate new functioning lobules thus mitigating some of the scarring damage. Blood flow to the liver may also increase to further compensate for the damage. What determines patient outcomes is the residual amount of liver function, not the extent of scarring. This was shown in the National Institutes of Health sponsored HALT-C trial which concluded that quantitative liver function “… may be superior to histological staging by liver biopsy in identifying both high- and low-risk groups and may be more accurate than staging fibrosis in predicting clinical outcomes”.
HEPATIQ is cleared for sale by the Food and Drug Administration. It provides 3 indices of liver disease that permit differential diagnoses not possible with one dimensional tests.
- PHM (perfused hepatic mass): Quantitates liver function.
- fSV (functional spleen volume): Indicator of portal hypertension.
- fLV (functional liver volume): Indicator of fatty liver disease.
Better Patient Management
The 8 year HALT-C trial showed that baseline PHM was significantly lower and fSV significantly larger in patients who subsequently experienced clinical outcomes including variceal bleeding, ascites, hepatic encephalopathy, and liver-related death. This trial also showed that Ishak fibrosis stage dropped from significance in the prediction of clinical outcomes in models that included PHM or fSV. Perhaps even more important, characterization of a patient as low risk by quantitative liver function was associated with a very low risk for adverse clinical outcome. PHM and fLV were also shown to precisely track liver function and volume regeneration after an adult-to-adult live donor liver transplant in the A2ALL study.