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LIVER TESTS

Hospitals spend $12 billion/year [A] on liver tests that provide modest predictive value [B,C]. The HEPATIQ® test predicts disease outcomes better by quantifying remaining liver function [5,6,12,13,16,17,21,22,24]. Alternative tests measure or score liver fibrosis (or scar tissue in the liver) but do not quantify remaining liver function. The problem with measuring just fibrosis is that the liver regenerates new functioning tissue and blood flow to the liver increases to get more function out of the remaining good tissue. Fibrosis measurements miss the effect of regeneration and the hemodynamic response to fibrosis. [8,13,16,17,19,20,21,22,27] HEPATIQ® uses new patented software to analyze liver-spleen SPECT images and provide six indices of liver disease from a single 20 minute scan: quantitative liver function, steatosis/steatohepatitis, portal hypertension, alcoholic hepatitis, fibrosis stage and variceal size.[5-28] HEPATIQ® is the only FDA cleared product on the market that quantifies remaining liver function. To use a car analogy, all other tests estimate the air in the gas tank. That won’t tell you how far the car will travel. HEPATIQ® measures the gas in the gas tank.

TESTIMONIAL

Dr. Kip Lyche, Gastroenterologist. Community Memorial Health System
"I have been using HEPATIQ in my gastroenterology practice and published a poster titled “Revolutionizing Care in Cirrhotic Patients Using HEPATIQ in a Community Setting” at the AASLD Liver Meeting in November 2022. Unlike the Child-Pugh class and the MELD score which indicate damage to the liver, the HEPATIQ indices provide true quantification of remaining liver function. Serial HEPATIQ testing has improved care for patients in my practice by providing accurate prognostic assessments based on trends in the PHM index of liver function. I believe HEPATIQ can provide early detection of progressive liver disease prompting a vigilant evaluation for complications."

LIVER FUNCTION

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 liver also excretes bile which helps to break down fats, preparing them for further digestion.
Life is not possible without a functioning liver. Infections, alcohol and fat build-up can affect liver function by causing the accumulation of fibrosis or scar tissue in the liver (whitish regions in the figure). Biopsies, elastography and blood tests measure or score liver fibrosis but do not quantify remaining function.
Patient outcomes are determined by the liver functional reserve, not the extent of fibrosis. This was established in the 8 year, prospective, multi-center HALT-C trial, which indicated that quantitative liver function is more accurate than staging fibrosis in predicting clinical outcomes.[5,6] Subsequent clinical research has further confirmed that function outperforms fibrosis in predicting outcomes.[12,13,16,17,21,22,24] Liver functional reserve is measured by the perfused hepatic mass (PHM) with normal function being PHM>100.[4] A large, badly scarred, stiff liver can have normal function if there are enough functional nodules and adequate blood flow. Once a patient’s PHM drops below 75, they may decompensate, that is, develop clinical problems.[5,6,11,14,19,20,24] If their PHM falls below 60, they may die if not transplanted soon. [10,15,18]
The HEPATIQ report shows six indices: PHM (liver function), fLV (liver volume), fSV (spleen volume), HAI (alcoholic hepatitis), eFS (estimated fibrosis) and eEV (estimated varices). These indices are used for diagnosis, staging, interventions, and monitoring liver disease progression. They help identify those at risk of ascites, variceal bleeding, hepatic encephalopathy and liver-related death.[5,6,10,11,14,15,16,18,19,20,23,24,25,26] Differentials of these indicate steatotic liver disease, steatohepatitis, alcoholic hepatitis, cirrhosis, portal hypertension, varices and infiltrative spleen disease.[5,6,8,11,14,16,21,22,23,25] HEPATIQ also provides the H0-H5 physiological stage of liver disease.[27,28]

Comparative Analysis

Predictive ability of blood test based fibrosis scoring systems, such as APRI, FIB-4, NFS, etc., to identify persons with advanced fibrosis associated with development of cirrhosis is modest [B]. Fibrosis scores have poor sensitivity for predicting advanced liver disease in diabetic patients [C]. Elastography or a biopsy may be performed for staging liver disease (F0-F4) but they don't provide information on liver functional reserve. It may be beneficial to use HEPATIQ to assess liver functional reserve for patients designated as abnormal (>F0) [12,13,17,22]. Furthermore, before a liver surgery or any liver interventional procedure, use HEPATIQ to assess liver functional reserve [D].

PURCHASING INFORMATION

HEPATIQ® -The Ultimate Liver Test™ may be purchased for $95 per report. To proceed, please fill in the information below and we will set up an online account for you.