Functional Molecular Imaging In Hepatology


by

Susanne Keiding, Michael Sørensen

DOI: 10.2174/97816080529051120101
eISBN: 978-1-60805-290-5, 2012
ISBN: 978-1-60805-677-4



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The eBook discusses how the special physiology of the liver must be considered when applying functional molecular imaging in hepatolog...[view complete introduction]
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Table of Contents

Introduction

- Pp. i

Sussane Keiding and Michael Sorensen

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Foreword

- Pp. ii

Hendrik Vilstrup

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Preface

- Pp. iii

Susanne Keiding and Michael Sørensen

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List of Contributors

- Pp. iv-vi (3)

Susanne Keiding and Michael Sørensen

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Functional Anatomy of Liver Circulation

- Pp. 3-13 (11)

Carlo Merkel, Sara Montagnese and Piero Amodio

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Measurements of the Liver’s Total Blood Flow and Regional Perfusion

- Pp. 14-23 (10)

Susanne Keiding and Ole Lajord Munk

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Combining Compartmental and Microvascular Models in Interpreting Dynamic PET Data

- Pp. 24-31 (8)

Ole Lajord Munk, Susanne Keiding and Ludvik Bass

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Calculating the Metabolic Clearance of a Mother Substance from the Clearance of its Analogue Tracer Measured by PET

- Pp. 32-36 (5)

Ludvik Bass, Michael Sørensen, Ole Lajord Munk and Susanne Keiding

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Hepatic Glucose and Fatty Acid Metabolism

- Pp. 37-48 (12)

Patricia Iozzo and Pirjo Nuutila

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Biliary Secretion

- Pp. 49-75 (27)

Kim Frisch and Alan F. Hofmann

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Metabonomic Analysis in Liver Diseases

- Pp. 76-86 (11)

Laia Chavarria, Ignasi Barba and Juan Córdoba

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Hepatocellular Carcinoma

- Pp. 87-94 (8)

Michael Sørensen

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Cholangiocarcinoma

- Pp. 95-103 (9)

Hanne Prytz

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Liver Metastases from Colorectal Cancers

- Pp. 104-119 (16)

Laurie B. Jones-Jackson, Ronald C. Walker and Dominique Delbeke

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Neuroendocrine Tumours with Secondary Liver Lesions

- Pp. 120-128 (9)

Valentina Ambrosini, Davide Campana, Paola Tommassetti and Stefano Fanti

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Brain Energy and Ammonia Metabolism

- Pp. 129-144 (16)

Lasse K. Bak, Arne Schousboe and Helle S. Waagepetersen

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Cerebral Glucose Metabolism in Patients with Liver Cirrhosis and Hepatic Encephalopathy

- Pp. 145-152 (8)

Karin Weissenborn and Alan H. Lockwood

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Cerebral Ammonia Metabolism in Cirrhosis

- Pp. 153-159 (7)

Michael Sørensen and Peter Ott

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Magnetic Resonance Studies of the Brain in Liver Disease

- Pp. 160-182 (23)

Mark J.W. McPhail, Howard C. Thomas and D. Taylor-Robinson Simon

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Author Index

- Pp. 183

Susanne Keiding and Michael Sørensen

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Subject Index

- Pp. 184-185 (2)

Susanne Keiding and Michael Sørensen

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Foreword

It is truly amazing what has happened with our understanding of liver physiology and pathophysiology over the last decades. We had black-box perceptions of what goes on in the liver as it could be judged from events in the systemic blood stream – much like earlier times’ understanding of the white spots on the maps of the big continents from what comes out with the rivers. Now, we have observational and experimental, non-invasive, true time, in vivo, direct, visualizing, functional, and molecular methods and we are eagerly filling up the canyons of lack of knowledge. This eBook reports a contemporary up-to-date snap-shot of this development. And better: this eBook is not a description of a completed travel after the main station has been reached – it is merely a situation report from a humble halt from which we know the train will continue up the tracks with increasing pace and load. This scientific journey brings to mind the famous words of one of the greatest hepatologists of all times, Danish Niels Steensen (1638-1686): “Beautiful is what we see; more beautiful is what we perceive; but most beautiful of all is what we do not perceive”. Thus encouraged and spirited, I recommend this eBook to discerning readers of the poetry and epic of what the liver really is and does.

Hendrik Vilstrup
Professor of Medicine and Hepatology
Aarhus University
Denmark


Preface

When we initiated this eBook, it was because we felt that a collected overview of the scientific and clinical use and possibilities of functional molecular imaging in hepatology was needed. To make the eBook as comprehensive as possible, we invited internationally renowned experts to make contributions. We are aware that a comprehensive textbook will never be fully up-dated at the time of publication, especially not within a field that is so rapidly evolving. We are therefore grateful that the authors and Bentham Science Publishers have made it possible to publish the eBook within 2 years of its initiation.

The functional aspects of the special arrangement with a dual blood supply to the liver and the microvascular architecture with highly permeable liver sinusoids are discussed in Chapters 1-3. These aspects are important to consider when employing functional molecular imaging in studies of hepatic blood perfusion and metabolism. For example, compartmental models are widely used for analysis of dynamic PET data and have been proven useful in many contexts, but as they are unable to deal with physiological effects of blood flow through the sinusoids, they should not be applied uncritically. The next Chapters of the eBook (Chapters 4-7) focus on how functional molecular imaging is and can be utilized to measure specific metabolic pathways in vivo in liver tissue by external detection. For analysis of PET data, this requires a priori knowledge of the distribution of the tracer used and its biochemical fate, whereas metabonomic analysis is the study of metabolic responses to liver diseases. Quantification of hepatic metabolism of glucose and fatty acids as well as biliary secretion in vivo is promising for the understanding of functional changes in relation to parenchymal liver disease and other diseases that may affect hepatic metabolic function and the area is evolving rapidly.

The ability to image specific metabolic pathways is fully exploited in the clinical management of patients with liver tumours (Chapters 8-11). 18F-FDG is widely used as a PET tracer for glucose metabolism which is increased in cancer tissue. The clinical impact of 18F-FDG PET/CT in the management of patients with colorectal liver metastases has been verified in many studies. 18F-FDG PET/CT may also be useful as a screening tool for cholangiocarcinoma in patients with increased risk for this disease but seems to be of limited value for the diagnosis of hepatocellular carcinoma and neuroendocrine tumours. In these cancers, however, other tracers of specific metabolic pathways are promising.

Brain homeostasis is susceptible to impaired liver function. As discussed in Chapters 12-15, functional molecular imaging has also been used to unravel some of the pathogenetic mechanisms behind the changes in brain blood perfusion and energy metabolism, especially the effects of increased blood ammonia concentrations.

We wish to thank all authors for an outstanding and dedicated work. We would also like to thank Gertrud Jørgensen for her invaluable help with the set-up of the eBook.

Susanne Keiding
Michael Sørensen
PET Centre and Department of Hepatology
Aarhus University Hospital
Denmark
Home page: www.liver.dk

List of Contributors

Editor(s):
Susanne Keiding
PET Centre, Department of Medicine V (Hepatology and Gastroenterology)
Aarhus University Hospital
Aarhus
Denmark


Michael Sørensen
PET Centre, Department of Medicine V (Hepatology and Gastroenterology)
Aarhus University Hospital
Aarhus
Denmark




Reviews

”Functional Molecular Imaging in Hepatology is a well-written, informative, and useful e-book by knowledgeable, dedicated authors. ….This textbook will be useful to hepatologists dealing with complex medical issues related to liver disease in their clinical practice.” – Usha Joseph, Journal of Nuclear Medicine – Society of Nuclear Medicine and Molecular Imaging, February 2014


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