Quantitative Liver Function

HEPATIQ precisely and non-invasively quantifies liver function by analyzing SPECT images. Other techniques such as biopsies, elastography and blood tests estimate or score liver fibrosis but do not quantify function. HEPATIQ is cleared for sale by the U.S.A. Food and Drug Administration.

Liver with extensive scarring and generation of new nodules.

LIVER DISEASE

The liver regulates chemical levels in the blood and excretes bile. Bile helps to break down fats, preparing them for further digestion and absorption. All of the blood leaving the stomach and intestines pass through the liver. The liver processes this blood and creates nutrients for the body to use. The body cannot live without a functioning liver. The basic functioning unit in the liver is a “lobule”. Liver function is largely determined by the number of functioning lobules and the rate of blood flow through them. As liver disease progresses, there may be a decrease in the number of functioning lobules, and changes in blood flow to them. Quantitative liver function (PHM) can be reduced by infections, alcohol and fat buildup that cause the accumulation of fibrosis or scar tissue. The liver can regenerate new functioning nodules, and blood flow to the liver may increase, providing some mitigation. A large, badly scarred, stiff liver can have normal function (PHM>100) if there are enough functional nodules. Once a patient’s PHM drops below 75, they may decompensate, that is, develop clinical problems. If their PHM falls below 60, they may die if not transplanted soon. If patients are treated and chronic liver injury is controlled, their PHM may improve. If PHM rises above 75, they may recompensate with recovery from clinical problems. Liver transplant restores function to normal.

Function Outperforms Fibrosis

Patient outcomes are determined by residual liver function, not the extent of fibrosis. This was established in the 8 year, prospective, multi-center, NIH sponsored HALT-C trial, which concluded that quantitative liver function may be more accurate than staging fibrosis in predicting clinical outcomes. Subsequent clinical research has further confirmed that function outperforms fibrosis in predicting outcomes.

Better Disease Management

The HEPATIQ report provides six quantitative indices of liver disease: PHM (quantitative liver function), fLV (liver volume), fSV (spleen volume), HAI (alcohol activity), eFS (fibrosis score) and eEV (esophageal varices). These indices are used for diagnosis, staging, interventions, and monitoring liver disease progression. They help identify those at risk of outcomes such as ascites, variceal bleeding, hepatic encephalopathy and liver-related death. Differentials of these indices indicate fatty liver, steatohepatitis (alcoholic and non-alcoholic), cirrhosis, portal hypertension, varices and infiltrative spleen disease.

Comparative Analysis