Dynamic SPECT Assessment of Hepatic Function in Patients With Liver Disease: A Systematic Review and Meta-Analysis.

INTRODUCTION: Dynamic Single Photon Emission Computed Tomography (dynSPECT) is an advanced functional imaging modality that enables estimation of temporal changes in radiopharmaceutical distribution and physiological function. While dynSPECT has been employed in several clinical applications, it has not been widely applied to liver imaging. This review aims to investigate the role and effectiveness of dynSPECT in assessing hepatic function. METHODS: Following PRISMA guidelines, literature searches were conducted in MEDLINE, PubMed, Scopus, Embase, IEEE, and Web of Science, including all publications available up to December 2025 that assessed liver function using dynSPECT imaging, standard laboratory function tests and clinical scoring systems. Search results were screened by two authors. Included studies were assessed for bias using the QUADAS-2 quality assessment test tool. RESULTS: Sixteen eligible studies were incorporated in this review, involving 715 participants, of whom 87% (624) had hepatic diseases. Meta-analysis revealed correlations between dynSPECT measures of liver function and the laboratory tests, including Hepaplastin (r = 0.5471; 95% CI: 0.4523 to 0.6418), Indocyanine Green (ICG) (r = -0.461; 95% CI: -0.831 to -0.081), and Bilirubin (r = -0.425; 95% CI: -0.714 to -0.14). Furthermore, the comparison between the two dynSPECT parameters and clinical scoring systems, including the Child-Pugh score, MELD, and the histologic activity index (HAI), has a significant effect on liver disease assessment, with a combined p-value < 0.001. CONCLUSION: DynSPECT is a useful tool for the assessment of liver function in patients with hepatic dysfunction, providing results comparable to clinical laboratory function tests and scoring systems.