A technique for the computerized analysis of the kinetic behavior of Tc-99m labeled hepatobiliary agents is described. Both blood and extravascular background correction of sequential camera images is used. The results of the analysis of blood, liver and bile concentrations are analyzed using a compartmental model containing two parallel liver compartments. Results in ten patients indicate that in all liver disease cases regurgitation was markedly increased. In complete obstruction of the bile ducts there was irreversible liver uptake, suggesting intrahepatic cholestasis and decreased blood clearance. In alcoholic hepatitis there was an increase in clearance thought to be due to increased hepatic artery blood flow. The present study describes a computerized method of collecting and analyzing sequential images of the liver following the administration of one of the new Tc-99m labeled hepatobiliary agents, pyridoxylideneglutamate (PC). The transfer constants describing the transfer of PC from blood to liver and bile are derived from the fit of the net activity in the blood, liver, and bile as a function of time to a suitable compart mental model having two liver compartments. The transfer constants from blood to liver and liver to bile appear to be very promising, not only as a means of diagnosing the kind of liver disease, but also the severity of the pathophysiologic changes present.
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