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HEPATIQ REPORT
The HEPATIQ report provides six indices of liver disease that may be used for diagnosis, staging, interventions, and monitoring disease progression. It includes color-coded serial and differential graphs and an interpretation of the quantitative indices including a physiologic stage of liver disease. A sample report is shown below for illustration.
- HEPATIQ Indices
- The HEPATIQ report provides six indices of liver disease that may be used for diagnosis, staging, interventions, and monitoring disease progression.
- (1) PHM - Quantitative Liver Function (normal ≥100). PHM indicates likelihood of liver decompensation. Patients with PHM < 95 have cirrhosis and a 15-fold increase in the risk of outcomes such as ascites, variceal bleeding, hepatic encephalopathy, and death.[4,5,6,10,15,16,18,19,20,24]
- (2) fLV - Liver Volume (7 ≤ normal < 12). fLV indicates steatotic liver disease when high and shrinking functional volume when low.[8,11,14,21,22,23]
- (3) fSV - Spleen Volume (normal < 2.5). fSV provides a non-invasive measure of portal hypertension.[5,6,10,12,13,15,19,20] May be used for assessing a transjugular intrahepatic portosystemic shunt (TIPS).
- (4) HAI - Alcoholic Index (normal > -0.1). HAI indicates alcoholic hepatitis when low.[10,15,18,19,20,23,24]
- (5) eFS - Fibrosis Stage (normal = 0, range 0 to 6). eFS estimates fibrosis stage and correlates with Ishak fibrosis.[5,6]
- (6) eEV - Esophageal Varices (normal =0, range 0 to 3). eEV estimates presence and size of esophageal varices and the risk of bleeding.[5,6]
Differential Diagnostics(1) PHM and fLV can be used to differentiate steatohepatitis and non-steatotic cirrhosis.[8,10,11,14,21,22] (2) PHM and fLV reflect intrahepatic hemodynamics allowing differentiation of acute and chronic liver disease.[6,8,10,11,25] (3) PHM and fSV can be used to differentiate infiltrative spleen disease and cirrhotic portal hypertension.[6,12,15,19] (4) HAI and fLV allow differentiation of alcoholic steatohepatitis (ASH) and metabolic dysfunction-associated steatohepatitis (MASH).[8,10,14,18,21,22,23]
Physiologic Stage
Besides providing the fibrosis stage, HEPATIQ also estimates the physiologic stage of liver disease [1-25]:
H0 Normal liver function. H1 Severe acute liver disease. H2 Steatotic liver disease. H3 Compensated cirrhosis. H4 Decompensated cirrhosis. H5 Liver transplant candidate.
Managing Disease Progression(1) Interventions: For HCC patients being considered for radioembolization or chemotherapy, PHM indicates possibility of post-intervention liver failure.[6,10,13,15] (2) Transplantation: For patients with severe liver disease but MELD score not high enough for transplant priority, low PHM may be used to justify a MELD exception for liver transplantation.[6,10,15,18] (3) Therapy: PHM provides objective monitoring of the efficacy of pharmacological, radiological or surgical therapies for the underlying causes of liver disease.[6,10,15,18,24]
(4) Vigilance: HEPATIQ can provide early detection of progressive liver disease prompting a vigilant evaluation for complications.[24,25]