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The combination of 4D-cholate (cholic acid-2,2,4,4-d₄) and 13C-cholate (cholic acid-24-¹³C) is used as a diagnostic agent in the HepQuant SHUNT test to quantitatively assess liver function. In this dual-isotope test: - 4D-cholate is administered orally and measures clearance from the portal circulation. - 13C-cholate is administered intravenously and measures clearance from the systemic circulation. Timed blood samples are collected after administration to calculate hepatic filtration rates and estimate portal-systemic shunting. This approach provides a minimally invasive alternative for evaluating global liver function in patients with various liver diseases including cirrhosis and nonalcoholic fatty liver disease[1][2][3][9].
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