Nuclear Hepatology – A Textbook of Hepatobiliary Diseases 2nd Edition PDF
10.78 MB PDF
Since the publication of the first edition of Nuclear Hepatology almost 10 years ago, new advances have taken place, both in our understanding of liver pathophysiology and various imaging modalities. A unique feature of imaging of physiology is that it enables quantification. Since liver physiology is complex, quantification has been a challenge. Many publications in the past have often included quantification based on home-made software not available for others. Thus, the comparison of results from one center to another becomes difficult, if not impossible. The second edition of Nuclear Hepatology addresses these issues. Sophisticated software for liver and gallbladder function has been tested and validated through many of our previous publications. Now that software is FDA approved and available for others through a commercial company, it is hoped that future publications of imaging of liver and gallbladder physiology would routinely include quantification.
Although the function of the hepatocyte is complex, it can be broadly divided into two main categories, substrate uptake at the basolateral border and intracellular transit prior to excretion into the canaliculi. The earliest manifestation of hepatocellular injury occurs in the form of prolongation of the intracellular transit time, which occurs long before the disruption of the basolateral border with subsequent rupture and death. The liver enzymes are released into circulation after the death of the hepatocyte. Hepatocyte function can be restored completely by treating the patient as soon as the intracellular transit is altered, but not after the rupture of the basolateral border (cell death). Measurement of intracellular transit time from a Tc-99m HIDA study enables early detection of the hepatocyte injury and early therapeutic intervention.
Most of the chapters include updated information. The second chapter describes the latest information related to liver physiology and Chap. 5 provides sophisticated software quantification of pathophysiology. Cholescintigraphic images are correlated with morphologic images obtained with ultrasound, CT or MRI. Since PET/CT imaging has currently become a standard in the care of the cancer patient, a detailed description is provided in Chap. 12. Latest information on biliary dyskinesia in adults and neonatal hepatitis in infants is updated. It is our firm belief that physicians, surgeons, and pediatricians caring for patients with liver and gallbladder disease would become more familiar with the latest advances in imaging technology and provide the best care for their patients, based on evidence from objective parameters.
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