Comparative quantitative evaluation of hepatic clearance of diethyl-IDA and para-butyl-IDA in jaundiced and non-jaundiced patients

A method for comparative measurement of hepatic clearance of different hepatobiliary agents is described and the clinical use of diethyl-IDA and parabutyl-IDA is discussed. The study was performed with both radiopharmaceuticals in 13 patients with hepatobiliary disease with serum bilirubin ranging from 0.3 to 16.4 mg/100 ml. Diethyl-IDA is preferable for a qualitative evaluation of hepatobiliary disease because of its higher hepatic clearance and faster biliary excretion rate. Parabutyl-IDA is superior for measuring the hepatocytic uptake function, due to the low urinary excretion and the absence of an apparent re-entry from liver to plasma, even in patients with obstructive jaundice. In contrast, an appreciable re-entry can be demonstrated for diethyl-IDA.