Abstract
Interferon (IFN) provides effective treatment in some patients with chronic hepatitis. The clarification of factors predictive of therapy response would be helpful in identifying patients who would benefit from treatment. In this study, we evaluated the potential utility of Tc-99m sulfur colloid liver/spleen and Tc-99m-disofenin hepatobiliary scintigraphy to predict therapy response to IFN in patients with chronic active hepatitis. The study group consisted of ten patients with chronic viral hepatitis B who were treated with 4.5 units of interferon alpha for 12 months. Prior to the start of the therapy, sulfur colloid scintigraphy was obtained by which the liver/spleen ratios were derived. Hepatobiliary scintigraphy was performed on a separate day and time-activity curves were generated from regions of interest drawn over the liver, heart and gall-bladder. The index of blood and liver clearance time was calculated. Histological grading and laboratory values were obtained for clinical correlation. Responders (n=6) to IFN were defined as those who improved clinically with normalized transaminase levels and had HBeAg seroconversion. On SC scintigraphy, the liver/spleen ratio of non-responders was significantly lower than responders (median values: 0.69 vs. 1.16, p=0.01) but on hepatobiliary scintigraphy no statistically significant parameters were found to predict response to interferon therapy.
References
Davis GL, Balart LA, Schiff ER, et al. Hepatitis Intervertional Therapy Group. Treatment of chronic hepatitis C with recombinant interferon alpha. A multicenter randomized controlled trial.N Eng J Med 1989; 321: 1501–1506.
Di Bisceglie AM, Martin P, Kassiandes C, et al. Recombinant interferon alpha therapy for chronic hepatitis C. A randomized, double-blind, placebo-controlled trial.N Eng J Med 1989; 321: 1506–1510.
Marcellin P, Boyer N, Giostra E, et al. Recombinant human alpha-interferon in patients with chronic non-A, non-B hepatitis: a multicenter randomized controlled trial from France.Hepatology 1991; 13: 393–397.
Yoshioka K, Higashi YK, Yamada M, et al. Predictive factors in the response to interferon therapy in chronic hepatitis C.Liver 1995; 15: 57–62.
Soresi M, Tripi S, Cartabellota A, et al. Factors predicting the response to alpha-interferon therapy in patients with chronic hepatitis C.Recenti Prog Med 1996; 87: 154–157.
Knodell RG, Ishak KG, Black WC, et al. Formation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis.Hepatology 1981; 1: 431–435.
Hoofnagle JH, Alter HJ. Chronic viral hepatitis. In: Vyas GN, Dienstag JL, Hoofnagle JH, eds.Viral Hepatitis and Liver Disease. New York: Grune Stratton, 1984: 97–113.
Mullhaupt B, Renner EL. Therapy of chronic hepatitis B and C.Schweiz Rundsch Med Prax 1999; 88: 619–632.
Mazzela G, Accogli E, Sottili S, et al. Alpha interferon treatment may prevent hepatocellular carcinoma in HCV-related liver cirrhosis.J Hepatol 1996; 24: 141–147.
Shindo M, Di Bisceglie AM, Cheung L, et al. Decrease in serum hepatitis C viral RNA during alpha-interferon therapy for chronic hepatitis C.Ann Intern Med 1991; 115: 700–704.
Hasegawa K, Hasegawa M, Kusakabe K, et al. Evaluation of usefulness of Tc-99m GSA scintigraphy in patients with hepatitis C treated with alpha interferon.Nippon Igaku Hoshasen Gakkai Zasshi 1994; 25: 804–806.
Van Thiel DH, Friedlander L, Malloy P, et al. Gamma-Glutamyl transpeptidase as a response predictor when using alpha-interferon to treat hepatitis C.Hepatogastroenterology 1995; 42: 888–892.
Mettler FA, Guiberteau MJ (eds).Essentials of Nuclear Medicine Imaging. Philadelphia, WB Saunders Company, 1991: 177–207.
Boucher E, Bourienne A, Adams P, et al. Liver iron concentration and distribution in chronic hepatitis C before and after interferon treatment.Gut 1997; 41: 115–120.
Martin-Vivaldi R, Nogueras F, Gonzales A, et al. Response of chronic hepatitis C to interferon-alpha treatment and relationship with iron metabolism.Rev Esp Enferm Dig 1997; 89: 523–530.
Reizis AR, Nikitina TS, Shalygina NB, et al. Functional metabolic activity of the mononuclear phagocyte system of the blood, liver, spleen and skin in children with hepatitis B.Pediatriia 1990; 8: 54–59.
Harvey E, Loberg M, Ryan J. Hepatic clearance mechanism of Tc-99m HIDA and its effect on quantitation of hepatobiliary biliary function: concise communication.J Nucl Med 1979; 20: 310–313.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Caglar, M., Sari, O. & Akcan, Y. Prediction of therapy response to interferon-alpha in chronic viral hepatitis-B by liver and hepatobiliary scintigraphy. Ann Nucl Med 16, 511–514 (2002). https://doi.org/10.1007/BF02988654
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02988654