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• W4353082144 abstract "Background Functional liver reserve is an important determinant of survival in cirrhosis. The traditional indocyanine green test (ICG) is cumbersome. Hence, we developed and validated a novel liver imaging, a hybrid of SPECT and CT (Q-SPECT/CT), for evaluating disease severity, outcomes, and response to treatment in decompensated cirrhosis (DC). Methods We recruited a cohort of DC patients at a tertiary institute between 2016–2019. First, we standardized the Q-SPECT/CT across a predefined range of volumes through phantom experiments. Then we performed clinical and laboratory evaluations, ICG test (retention at 15 min), and Q-SPECT/CT at baseline and 12 months of granulocyte colony-stimulating factor (G-CSF) and standard medical treatment (SMT). Results In 109 DC patients, 87.1% males, aged 51 ± 10 years, MELD: 14 (7–21), the percent quantitative liver uptake (%QLU) on Q-SPECT/CT exhibited a strong correlation with CTP ( r = −0.728, p &lt; 0.001), MELD ( r = −0.743; p &lt; 0.001) and ICG-R-15 ( r = −0.720, p &lt; 0.001) at baseline. %QLU had the maximum discrimination (AUC: 0.890–0.920), sensitivity (88.9–90.3%), specificity (81.2–90.7%), and accuracy (85.8–89.4%) than liver volumes on Q-SPECT/CT or ICG test for classifying patients in CTP/MELD based prognostic categories. A significant increase in %QLU (26.09 ± 10.06 to 31.2 ± 12.19, p = 0.001) and improvement in CTP/MELD correlated with better survival of G-CSF treated DC patients ( p &lt; 0.05). SMT did not show any improvement in Q-SPECT/CT or clinical severity scores ( p &gt; 0.05). %QLU &gt; 25 (adj.H.R.: 0.234, p = 0.003) and G-CSF treatment (adj.H.R.: 0.414, p = 0.009) were independent predictors of better 12-months survival in DC. Conclusion Q-SPECT/CT (%QLU) is a novel non-invasive, diagnostic, prognostic, and theragnostic marker of liver reserve and its functions in cirrhosis patients. Clinical trial registration Clinicaltrials.gov , NCT02451033 and NCT03415698." @default.
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• W4353082144 date "2023-03-22" @default.
• W4353082144 modified "2023-10-18" @default.
• W4353082144 title "Quantitative liver SPECT/CT is a novel tool to assess liver function, prognosis, and response to treatment in cirrhosis" @default.
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• W4353082144 doi "https://doi.org/10.3389/fmed.2023.1118531" @default.
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