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Background
Since its advent, Tc-99m-labeled hepatobiliary iminodiacetic acid (HIDA) scintigraphy has been heavily utilized for the purposes of diagnostic and functional imaging of the hepatobiliary system. One interesting application is for the noninvasive evaluation of hepatocellular function. As an example, it can be used for preoperative evaluation of future remnant liver prior to resection, or for post liver transplantation monitoring. At present, evaluation of hepatocellular function via HIDA scan analysis is a qualitative process used as an adjunct to assessment of systemic serum markers of liver function. With advances in intelligent imaging software, quantitative analysis of HIDA scans may assist in more robust characterization of liver-specific disease.

Educational Goals / Teaching Points
The purpose of this educational exhibit is to introduce a means of quantitatively characterizing hepatocellular function through imaging software-mediated analysis of 99mTc-HIDA scans. In doing this, we may contribute to the development of a new mechanism for assessing hepatocellular function that goes beyond qualitative HIDA scan analysis, or evaluation of systemic serum markers of liver function.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this educational exhibit, we will present images and data from retrospective, syngo.via imaging software-mediated analysis of 99mTc-HIDA scans performed in 10 patients with known liver disease and 10 patients without liver dysfunction.

Conclusion
Quantitative parameters such as time to maximum (Tmax) radiotracer concentration and the time from T-max to 50% washout (T-half-max) liver clearance, can be successfully generated and used in patients with mild, moderate, and severe liver dysfunction. Patients with liver dysfunction showed quantifiable decreased/delayed clearance of the tracer from the liver.