Extensive Clinical Research
1. Quantitative Liver Function Tests Improve the Prediction of Clinical Outcomes in Chronic Hepatitis C: Results From the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis Trial. Gregory T. Everson, Mitchell L. Shiffman, John C. Hoefs, et. al.; HEPATOLOGY 2012; volume 55: pages 1019-1029.
HALT-C trial showed PHM and fSV predict likelihood of clinical outcomes such as ascites, variceal bleeding, hepatic encephalopathy, and liver-related death. Patients with low PHM have a 15-fold increase in risk and PHM may be more accurate than staging fibrosis in predicting clinical outcomes. Download Abstract.
2. Functional Elements Associated with Hepatic Regeneration in Living Donors after Right Hepatic Lobectomy. Gregory T. Everson, John C. Hoefs, Claus U. Niemann, Kim M Olthoff, Robert Dupuis, Shannon Lauriski, Andrea Herman, Norah Milne, Brenda W. Gillespie, Nathan P. Goodrich and James E. Everhart; LIVER TRANSPLANTATION, Vol. 19, No. 3, 2013.
Liver volume fLV dropped to 1/3 of baseline after live donation. Liver function PHM dropped to only 1/2 of baseline due to compensatory blood flow increase to the liver and recovered to normal in about six months. Download Abstract.
3. Physiologic Staging in Alcoholic Liver Disease Predicts Death and Monitors Recovery, John Hoefs, European Association for the Study of the Liver, THE INTERNATIONAL LIVER CONGRESS, 2017.
Patients with PHM < 60 are at high risk of death unless transplanted. PHM and fLV help in monitoring recovery for alcoholic hepatitis where large liver volumes may decrease before liver function improves.
4. Steatohepatitis: Differential Features on Quantitative Liver-Spleen Scan (QLSS), John Hoefs, European Association for the Study of the Liver, THE INTERNATIONAL LIVER CONGRESS, 2017.
HEPATIQ is effective in separating the major causes of chronic liver disease (CLD). Increased fLV helps differentiate fatty liver disease (FLD) - alcoholic hepatitis and non-alcoholic FLD - from non-steatotic CLD.
5. Shear Wave Elasticity (SWE) Unreliable in Detection of Cirrhosis, John Hoefs, American Association of the Study of Liver Diseases, THE LIVER MEETING, 2018.
Estimated METAVIR fibrosis score (eMFS: 0-4) by Shear Wave Elasticity (SWE) was unreliable in detecting cirrhotics. Most cirrhotics (METAVIR F4) had eMFS < 4, thus making SWE unreliable in detecting cirrhosis.
6. Physiologic Staging with Hepatiq Predicts Cirrhosis Better Than Shear Wave Elasticity, John Hoefs, American Association of the Study of Liver Diseases, THE LIVER MEETING, 2018.
Shear Wave Velocity (SWV) correlated poorly with cirrhosis even in those with decompensation. SWV did not correlate with quantitative hepatic function and is not a surrogate marker for function.
7. Small Liver Volumes: Cause and Significance, John Hoefs, The Liver Meeting, HEPATOLOGY, October 2019.
Small fLV (<7 cc/lb) is associated with more advanced liver disease and acute liver injury. Very small liver volumes (<5 cc/lb) are associated with advanced chronic liver disease and poor prognosis.
8. Quantitative Hepatic Function Predicts Time to Death After Diagnosis of Hepatocellular Carcinoma (HCC), John Hoefs, DIGESTIVE DISEASE WEEK, 2020.
Quantitative hepatic function predicts time to death after diagnosis of hepatocellular carcinoma (HCC).
9. Liver Surface Nodularity as an Estimate of Quantitative Liver Function and Portal Hypertension, John Hoefs, DIGESTIVE DISEASE WEEK, 2020.
Functional staging with HEPATIQ that directly measures hepatic function PHM, spleen volume fSV, and predicts clinical outcomes is superior to nodular surface measurements by ultrasound.
10. Is Physiologic Staging of Chronic Liver Disease Possible with Ultrasound? John Hoefs, American Association of the Study of Liver Diseases, THE LIVER MEETING, 2020.
Physiologic staging of advanced Chronic Liver Disease is inaccurate with ultrasound shear wave velocity measurements.
11. Quantitative Liver Spleen Scan Can Predict the Outcome in Patients with Alcoholic Hepatitis, M.A. Hashim, M.S. Ismail, W.H. Moore, M.M. Hassan, J. Hoefs & P. Jalal, American Association of the Study of Liver Diseases, THE LIVER MEETING, 2020.
PHM is significantly correlated with MELD Score and may predict the clinical outcome of patients with alcoholic hepatitis. Download Abstract.
12. HEPATIQ Predicts Cirrhosis and Decompensation, J. Hoefs, American Association of the Study of Liver Diseases, THE LIVER MEETING, 2021.
PHM and fSV predicted cirrhosis. PHM < 95 identified cirrhotic patients with decompensation at baseline or within 4 years. Cirrhotic patients with a PHM > 95 did not have decompensation at baseline or over the next 4 years. Download Abstract.
14. Large Functional Liver Volume (fLV) and ATI Combined in the Diagnosis of Steatohepatitis, J. Hoefs, DIGESTIVE DISEASE WEEK, 2022.
In patients with alcoholic or non-alcoholic fatty liver, livers with lower fat and large size have more advanced CLD. Patients with moderate to severe fat and large livers are primarily overweight females with pre-cirrhotic NASH. Download Abstract.
15. The functional liver volume (fLV) by HEPATIQ is superior to ATI in the diagnosis of steatohepatitis, J. Hoefs, Society of Nuclear Medicine and Molecular Imaging Conference 2022.
fLV is superior to ATI in the diagnosis of steatohepatitis. The value of fLV over ATI suggests there are other causes of hepatic enlargement in addition to fat and measuring fat alone may not be sufficient to identify or follow most cases of steatohepatitis. Download Abstract.
16. HAI by Hepatiq: Marker for ALD or for alcoholic hepatitis?, John Carl Hoefs, MD., American Association of the Study of Liver Diseases, THE LIVER MEETING, 2022. HAI < -0.09 is strongly suggestive of acute alcoholic hepatitis. HAI is diagnostically useful differentiating recent severe acute alcoholic injury from recovered ALD and other non-alcoholic liver diseases. Download Abstract.
17. Revolutionizing Care in Cirrhotic Patients Using HEPATIQ in a Community Setting, Thatcher Huynh, DO; Bethany Lyche; Kip Lyche, MD, American Association of the Study of Liver Diseases, THE LIVER MEETING, 2022.
Tracking disease progression with serial HEPATIQ tests can predict outcomes based on trends in PHM. Evaluation of liver with Child-Pugh and MELD scores addresses liver damage but HEPATIQ focuses on true hepatic function. HEPATIQ can provide early detection of progressive liver disease prompting a vigilant evaluation for complications. Download Abstract.