Background/Aims
Hepatic perfusion plays an important role in liver physiology and disease. This study
was undertaken to (a) validate the use of Positron Emission Tomography (PET) and oxygen-15-labeled
water ([15O]H2O) to quantify hepatic and portal perfusion, and (b) examine relationships between
portal perfusion and liver glucose and lipid metabolism.
Methods
Liver [15O]H2O-PET images were obtained in 14 pigs during fasting or hyperinsulinemia. Carotid
arterial and portal venous blood were sampled for [15O]H2O activity; Doppler ultrasonography was used invasively as the reference method. A
single arterial input compartment model was developed to estimate portal tracer kinetics
and liver perfusion. Endogenous glucose production (EGP) and insulin-mediated whole
body glucose uptake (wbGU) were determined by standard methods.
Results
Hepatic arterial and portal venous perfusions were 0.15 ± 0.07 and 1.11 ± 0.34 ml/min/ml of tissue, respectively. The agreement between ultrasonography and [15O]H2O-PET was good for total and portal liver perfusion, and poor for arterial perfusion.
Portal perfusion was correlated with EGP (r = +0.62, p = 0.03), triglyceride (r = +0.66, p = 0.01), free fatty acid levels (r = +0.76, p = 0.003), and plasma lactate levels (r = −0.81, p = 0.0009).
Conclusions
Estimates of liver perfusion by [15O]H2O-PET compared well with those by ultrasonography. The method allowed to predict portal
tracer concentrations which is essential in human studies. Portal perfusion may affect
liver nutrient handling.
Abbreviations:
PET (Positron Emission Tomography), EGP (endogenous glucose production), wbGU (whole body glucose uptake), [15O]H2O (15-oxygen-labeled water)Keywords
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References
- Low-grade steatosis and major changes in portal flow as new prognostic factors in steroid-treated alcoholic hepatitis.Hepatology. 2004; 40: 1370-1378
- Splanchnic haemodynamics in non-alcoholic fatty liver disease: effect of a dietary/pharmacological treatment. A pilot study.Dig Liver Dis. 2004; 36: 406-411
- Hepatic blood flow and carbohydrate changes in man during fainting.J Physiol. 1951; 115: 442-455
- Effects of flow rate and insulin on triacylglycerol secretion by perfused rat liver.Am J Physiol. 1988; 255: E306-E313
- Focal spared areas in fatty liver caused by regional decreased portal flow.AJR Am J Roentgenol. 1988; 151: 300-302
- Peritumoral spared area in fatty liver: correlation between opposed-phase gradient-echo MR imaging and CT arteriography.Abdom Imaging. 2001; 26: 384-389
- Simultaneous measurement of hepatic and portal venous blood flow in the sheep and dog.Am J Physiol. 1969; 216: 946-952
- Measurement of hepatic blood flow.J Surg Res. 1985; 39: 470-481
- Measurement of liver blood flow using oxygen-15 labelled water and dynamic positron emission tomography: limitations of model description.Eur J Nucl Med. 1996; 23: 169-177
- Hepatic plethysmography.in: Lautt W.W. Hepatic circulation in health and disease. Raven Press, New York1981: 41-54
- Pulsed Doppler ultrasonic flowmeter: application to the study of hepatic blood flow.in: Granger D.N. Bulkley G.B. Measurement of blood flow applications to the splanchnic circulation. Williams & Wilkins, Baltimore1981: 395-398
- Assessment of liver microcirculation in human cirrhosis.J Clin Invest. 1982; 70: 1234-1244
- The effect of graded steatosis on flow in the hepatic parenchymal microcirculation.Transplantation. 1999; 68: 780-784
- Quantitative blood flow measurement of skeletal muscle using oxygen-15-water and PET.J Nucl Med. 1997; 38: 314-319
- Glucose uptake and perfusion in subcutaneous and visceral adipose tissue during insulin stimulation in nonobese and obese humans.J Clin Endocrinol Metab. 2002; 87: 3902-3910
- Quantification of regional myocardial blood flow in vivo with H215O.Circulation. 1984; 70: 724-733
- Brain blood flow measured with intravenous H215O. I. Theory and error analysis.J Nucl Med. 1983; 24: 782-789
- Brain blood flow measured with intravenous H215O. II. Implementation and validation.J Nucl Med. 1983; 24: 790-798
- The reproducibility of independently measuring human regional hepatic arterial, portal and total hepatic blood flow using [15O]water and positron emission tomography.Nucl Med Commun. 2003; 24: 497-501
- Using the spleen for time-delay correction of the input function in measuring hepatic blood flow with oxygen-15 water by dynamic PET.Ann Nucl Med. 1999; 13: 215-221
- Analysis of models for quantification of arterial and portal blood flow in the human liver using PET.J Comput Assist. 1996; 20: 135-144
- Determination of regional flow by use of intravascular PET tracers: microvascular theory and experimental validation for pig livers.J Nucl Med. 2003; 44: 1862-1870
- Quantification of liver glucose metabolism by positron emission tomography: validation study in pigs.Gastroenterology. 2007; 132: 531-542
- 18F-FDG assessment of glucose disposal and production rates during fasting and insulin stimulation: a validation study.J Nucl Med. 2006; 47: 1016-1022
- Insulin-mediated hepatic glucose uptake is impaired in type 2 diabetes: evidence for a relationship with glycemic control.J Clin Endocrinol Metab. 2003; 88: 2055-2060
- Impact of incretin hormones on beta-cell function in subjects with normal or impaired glucose tolerance.Am J Physiol Endocrinol Metab. 2006; 291: E1144-E1150
- The nitrous oxide method for the quantitative determination of cerebral blood flow in man: theory, procedure and normal values.J Clin Invest. 1948; 27: 476-483
SAAM Institute 1998 SAAM II User’s guide version 1.1.1. WA: SAAM Institute, Seattle.
- Tracer kinetics in biomedical research: from data to model.Kluwer Academic/Plenum, New York2001
- Statistical methods for assessing agreement between two methods of clinical measurement.Lancet. 1986; 1: 307-310
- Hepatic microcirculation assessed by positron emission tomography of first pass ammonia metabolism in porcine liver.Liver Int. 2005; 25: 171-176
- Dynamics of arterial and portal venous flow interactions in perfused rat liver: an intravital microscopic study.Am J Physiol. 1996; 271: G201-G210
- Simultaneous measurement of hepatic arterial and portal venous flows by transit time ultrasonic volume flowmetry.Surg Gynecol Obstet. 1988; 167: 65-69
- Hepatic arteriel flow volume and reserve in patients with cirrhosis: use of intra-arteriel Doppler and adenosine infusion.Gastroenterology. 1999; 116: 906-914
- Hepatic arteriel blood flow velocities: assessment by transcutaneous and intravascular Doppler sonography.J Hepatol. 2000; 32: 893-899
- Non-invasive quantification of liver perfusion with dynamic computed tomography and a dual-input one-compartmental model.Clin Sci (Lond). 2000; 99: 517-525
- Direct and indirect effects of insulin on glucose uptake and storage by the liver.Diabetes. 2002; 51: 1663-1671
- The effect of insulin and glucagon on splanchnic oxygen consumption.Liver. 2002; 22: 459-466
- Splanchnic and leg substrate exchange after ingestion of a natural mixed meal in humans.Diabetes. 1999; 48: 958-966
- Effects of systemic arterial hypoperfusion on splanchnic hemodynamics and hepatic arterial buffer response in pigs.Am J Physiol Gastrointest Liver Physiol. 2001; 280: G819-G827
- Hepatic indocyanine green uptake and excretion in a rabbit model of steatosis.Eur Surg Res. 2001; 33: 193-201
- Relationship between hepatic blood flow and overall metabolism: the hepatic arterial buffer response.Fed Proc. 1983; 42: 1662-1666
- Fatty liver in obesity: relation to Doppler perfusion index measurement of the liver.Scand J Gastroenterol. 2000; 35: 976-980
Article info
Publication history
Published online: March 04, 2008
Accepted:
January 16,
2008
Received in revised form:
December 28,
2007
Received:
September 4,
2007
Associate Editor: C.P. DayFootnotes
☆The authors who have taken part in the research of this paper declared that they do not have a relationship with the manufacturers of the materials involved either in the past or present and they did not receive funding from the manufacturers to carry out their research.
Identification
Copyright
© 2008 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
