Predictive value of Tc-99m galactosyl human serum albumin liver SPECT on the assessment of functional recovery after partial hepatectomy: a comparison with CT volumetry

Wakamatsu, Hideyuki; Nagamachi, Shigeki; Kiyohara, Shogo; Fujita, Seigo; Kamimura, Kiyohisa; Futami, Shigemi; Nishii, Ryuichi; Nagano, Motoaki; Kondou, Kazuhiro; Kai, Masahiro; Chijiiwa, Kazuo; Tamura, Shozo

doi:10.1007/s12149-010-0426-2

Cited by 16 publications

(5 citation statements)

References 15 publications

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“…Similar to previous reports [12,13,16], GSAR max and rGSAR max were significantly correlated with other conventional liver functional parameters on univariate analysis, and, therefore, these were thought to be useful as preoperative liver tests. Only preoperative total bilirubin was not correlated with rGSAR max in the present study, and the total bilirubin level in this series was selected to be less than 1.2 mg/dl.…”

Section: Discussionsupporting

confidence: 87%

“…Therefore, in the present study, the relationships of several clinical, functional, and surgical parameters with posthepatectomy morbidity were examined in our clinical setting, as in the preliminary study [15]. By considering the importance of rGSAR max , the decreased volume of the remnant liver was an important issue because the changes in GSAR max might be affected by high-volume resection, such as a major hepatectomy [13,16,17], which should be related to posthepatectomy complications including hepatic failure.…”

Section: Discussionmentioning

confidence: 99%

“…The advantage of this parameter is that it allows the evaluation of future remnant liver function in any part separated from the entire liver or resected liver. In addition, it allows the evaluation of postoperative short-term outcomes, as noted in previous reports [16]. Therefore, we hypothesized that decreased liver function in the remnant liver as measured by rGSAR max would be a more sensitive predictor of postoperative morbidity than GSAR max in the whole liver, which was examined in the preliminary study.…”

Section: Introductionmentioning

confidence: 86%

“…However, the significance of this parameter with respect to ascites on multivariate analysis has not been fully evaluated, and the serum hyaluronic acid (HA) level and platelet count were still independent predictors [15]. On the contrary, Kwon and colleagues recommended the GSAR max of the remnant liver (rGSAR max ) as the most powerful parameter to evaluate remnant liver function after hepatectomy [16,17]. The advantage of this parameter is that it allows the evaluation of future remnant liver function in any part separated from the entire liver or resected liver.…”

Section: Introductionmentioning

confidence: 99%

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Significance of the preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin in the future remnant liver

Tanoue

Nanashima

Yano

et al. 2019

Nuclear Medicine Communications

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Background The relationship between posthepatectomy complications and liver functional parameters was preliminary reported in a pilot study. The present study sequentially evaluated the clinical significance of maximal removal rate of technetium-99m-galactosyl human serum albumin (GSAR max ) in the future remnant liver (rGSAR max ) in patients to predict posthepatectomy complications.Methods Between 2010 and August 2017, GSAR max , rGSAR max , their difference (Dif), and the rGSAR max to GSAR max ratio were examined in 247 additional patients who underwent hepatectomy for liver and biliary diseases. Hepatectomy-related postoperative complications (i.e. longterm ascites, intra-abdominal infection, and hepatic failure) occurred in 73 (29.6%) patients. ResultsThe median and mean preoperative GSAR max values were 0.477 and 0.498 ± 0.166 mg/min, respectively; rGSAR max values were 0.341 and 0.366 ± 0.145 mg/min, respectively; Dif values were 0.105 and 0.132 ± 0.111 mg/ min, respectively; and the rGSAR max to GSAR max ratio values were 0.774 and 0.746 ± 0.177, respectively. Among these, the GSAR max and rGSAR max values were significantly correlated with the liver functional parameters ICGR15, LHL15, HH15, prothrombin activity, serum hyaluronic acid level, and platelet count (all P < 0.01). The rGSAR max values were significantly lower in patients with long-term ascites (P < 0.05), and the predictive cutoff values of rGSAR max were 0.290 mg/min; however, the multivariate logistic regression analysis showed that rGSAR max was not independently related to long-term ascites. ConclusionWhen accompanied by other functional liver reserve parameters, rGSAR max seemed to be an alternative liver functional parameter related to ascites. Nucl Med Commun 40:145-152

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Significance of the preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin in the future remnant liver

Tanoue

Nanashima

Yano

et al. 2019

Nuclear Medicine Communications

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“…The SPECT volumetry was obtained using thresholding technique [13][14][15]. We applied a threshold-level at a 25% of the maximum SPECT intensity, which was used in the clinical examination.…”

Section: Clinical Scansmentioning

confidence: 99%

Correction of liver displacement due to irregular respiration for SPECT images obtained using a multiple short-time acquisition with breath-holding technique

Ueda

Kudomi

Koike

et al. 2011

Radiol Phys Technol

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Recently, a new method for acquiring single photon emission computed tomography (SPECT) data during breath-holding with a high-speed rotation (HSR-SPECT) technique was applied to hepatic-function scintigraphy. This technique can suppress motion artifact caused by respiration. However, it is challenging to apply this technique to patients with respiratory problems. Our purpose in this study was to analyze projection data and correct liver displacement due to irregular respiration during technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin ((99m)Tc-GSA) liver SPECT scans. We calculated cross-correlation functions (CCFs) for both intra- and inter-projections to correct irregular projections by shifting them in the longitudinal direction enough to maximize the CCFs. We integrated all of the shifted projections and created a synthesis projection which was used to reconstruct SPECT images. To confirm the effectiveness of our method, we did both a phantom study and a clinical retrospective review. In the phantom study, blurring artifacts due to displacement were reduced using our method. Post-processing using our method showed improvements in the normalized mean square error values ranging from 0.18 to 0.06. Furthermore, our method showed no disadvantage or miss-correction if we applied our method to data without displacement. In the clinical review, our method improved the image clarity for patients who could not repeat consistent respiration. In both the phantom simulation and the clinical application, the results showed the usefulness of our method. The efficiency of our method has the potential to reduce the displacement problem caused by respiration and provides excellent matching SPECT/CT fusion images.

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Anesthesia for Patients with Hilar Chlolangiocarcinoma

Chan¹

2013

Hilar Cholangiocarcinoma

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Predictive value of Tc-99m galactosyl human serum albumin liver SPECT on the assessment of functional recovery after partial hepatectomy: a comparison with CT volumetry

Abstract: The GSA-RL calculated by 99mTc GSASPECT was a useful parameter for predicting postoperative liver function recovery that should be implemented before partial hepatectomy.

Cited by 16 publications

References 15 publications

Significance of the preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin in the future remnant liver

Significance of the preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin in the future remnant liver

Correction of liver displacement due to irregular respiration for SPECT images obtained using a multiple short-time acquisition with breath-holding technique

Anesthesia for Patients with Hilar Chlolangiocarcinoma

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