“…Type B, comprising one of the three outliers, showed a large increase in RLV but a small increase in RLU15 (Table 3B). Compared with morphological RLV, RLF values obtained from GSA scintigraphy are known to be better correlated with postoperative albumin level [15], prothrombin time [10], total bilirubin [10,15], preoperative indocyanine green retention rate at 15 min (ICGR 15) [9,10], and postoperative indocyanine green [6,15]. Therefore, in patients of type A, even if only a small increase in RLV is observed, a large increase in RLU15 is likely to indicate sufficient regeneration of the residual liver.…”
Section: Discussionmentioning
confidence: 99%
“…RLU15 is the value obtained by multiplying LU15 by the residual count ratio calculated from single-photon emission computed tomography. When evaluating residual liver function before hepatectomy, the desirable RLU15 value is reported to be more than 13 [10].…”
Section: Methodsmentioning
confidence: 99%
“…Residual liver uptake at 15 minutes (RLU15), which was reported by Koizumi et al ., is the cumulative residual liver accumulation rate of a GSA tracer 15 minutes after its injection, and it indicates residual liver function [9]. To safely perform hepatectomies, it has been reported that the RLU15 should theoretically [10] and clinically [2] be 13 or more. A co-author of the present manuscript has already reported the usefulness of using RLU15 to predict liver failure [2]; however, to date, there has been no evaluation of the effectiveness of PTPE using RLU15.…”
PurposeTo analyse the correlation between the fold change in residual liver volume (RLV) and residual liver uptake at 15 (RLU15) before and after percutaneous transhepatic portal vein embolisation (PTPE).Material and methodsBetween August 2010 and December 2016, 20 patients who underwent PTPE were retrospectively selected. Before and three weeks after PTPE, contrast-enhanced computed tomography (CECT) and Tc-99m GSA scintigraphy were performed to analyse the fold changes in RLV and RLU15, respectively, as well as their correlation.ResultsAfter PTPE, a significant increase was observed in the RLV (before: 464 ± 99 ml; after: 573 ± 118 ml, p = 0.004) and the RLU15 (before: 11.0 ± 2.9%; after: 17.7 ± 3.8%, p = 5 × 10-7). The fold increase of RLV and RLU15 in all patients was 1.25 ± 0.15 and 1.66 ± 0.33, respectively. No significant correlation was observed in the fold increase in both RLV and RLU15 (r = 0.14, p = 0.66). In patients no. 3 and 9, who were outliers, the increase in RLV was minimal and RLU15 increased greatly, and these 2 patients underwent radical hepatectomy after PTPE.ConclusionsNo correlation was observed between the fold increase in RLV and RLU15 before and after PTPE. In order to accurately evaluate the residual liver function, it should be considered necessary to evaluate not only by morphological CECT volumetry, but also by functional outcome of Tc-99m GSA scintigraphy.Residual liver volume may not necessarily reflect RLF. It may be possible to improve the radical resection rate by detecting the potential increase of RLF with RLU15 of Tc-99m GSA scintigraphy.
“…Type B, comprising one of the three outliers, showed a large increase in RLV but a small increase in RLU15 (Table 3B). Compared with morphological RLV, RLF values obtained from GSA scintigraphy are known to be better correlated with postoperative albumin level [15], prothrombin time [10], total bilirubin [10,15], preoperative indocyanine green retention rate at 15 min (ICGR 15) [9,10], and postoperative indocyanine green [6,15]. Therefore, in patients of type A, even if only a small increase in RLV is observed, a large increase in RLU15 is likely to indicate sufficient regeneration of the residual liver.…”
Section: Discussionmentioning
confidence: 99%
“…RLU15 is the value obtained by multiplying LU15 by the residual count ratio calculated from single-photon emission computed tomography. When evaluating residual liver function before hepatectomy, the desirable RLU15 value is reported to be more than 13 [10].…”
Section: Methodsmentioning
confidence: 99%
“…Residual liver uptake at 15 minutes (RLU15), which was reported by Koizumi et al ., is the cumulative residual liver accumulation rate of a GSA tracer 15 minutes after its injection, and it indicates residual liver function [9]. To safely perform hepatectomies, it has been reported that the RLU15 should theoretically [10] and clinically [2] be 13 or more. A co-author of the present manuscript has already reported the usefulness of using RLU15 to predict liver failure [2]; however, to date, there has been no evaluation of the effectiveness of PTPE using RLU15.…”
PurposeTo analyse the correlation between the fold change in residual liver volume (RLV) and residual liver uptake at 15 (RLU15) before and after percutaneous transhepatic portal vein embolisation (PTPE).Material and methodsBetween August 2010 and December 2016, 20 patients who underwent PTPE were retrospectively selected. Before and three weeks after PTPE, contrast-enhanced computed tomography (CECT) and Tc-99m GSA scintigraphy were performed to analyse the fold changes in RLV and RLU15, respectively, as well as their correlation.ResultsAfter PTPE, a significant increase was observed in the RLV (before: 464 ± 99 ml; after: 573 ± 118 ml, p = 0.004) and the RLU15 (before: 11.0 ± 2.9%; after: 17.7 ± 3.8%, p = 5 × 10-7). The fold increase of RLV and RLU15 in all patients was 1.25 ± 0.15 and 1.66 ± 0.33, respectively. No significant correlation was observed in the fold increase in both RLV and RLU15 (r = 0.14, p = 0.66). In patients no. 3 and 9, who were outliers, the increase in RLV was minimal and RLU15 increased greatly, and these 2 patients underwent radical hepatectomy after PTPE.ConclusionsNo correlation was observed between the fold increase in RLV and RLU15 before and after PTPE. In order to accurately evaluate the residual liver function, it should be considered necessary to evaluate not only by morphological CECT volumetry, but also by functional outcome of Tc-99m GSA scintigraphy.Residual liver volume may not necessarily reflect RLF. It may be possible to improve the radical resection rate by detecting the potential increase of RLF with RLU15 of Tc-99m GSA scintigraphy.
“…1 ). Remnant liver LU15 values of 13.0 and more were considered to represent a remnant liver with good liver function, according to Koizumi et al [ 9 , 13 ]. Fig.…”
BackgroundA novel index, total liver LU15, has been identified as a surrogate marker for liver function. We evaluated the ability of preoperative remnant liver LU15 values to predict postoperative hepatic failure.MethodsPreoperative risk factors for postoperative hepatic failure and remnant liver LU15 were evaluated in 123 patients undergoing liver resection for several diseases from September 1st, 2007 to December 1st, 2016. We calculated the remnant liver LU15 value from the total liver LU15 value and the functional remnant liver ratio. Risk factors for postoperative hepatic failure was determined by univariate and multivariate analysis.ResultsHepatic failure grade B/C developed postoperatively in six patients of seven patients within Makuuchi criteria / without criteria for remnant liver LU15. Operative time (p = 0.0242) and criteria for remnant liver LU15 (p = 0.0001) were prognostic factors for hepatic failure according to the univariate analysis. And criteria for remnant liver LU15 (p = 0.0009) was only prognostic factor by multivariate analysis.ConclusionBased on the findings form this pilot study, it appears that patients with a remnant liver LU15 value of 13 or less may have a high risk of postoperative hepatic failure.
“…Tanaka et al [57] demonstrated changes upon GSA time activity curves and questions have been answered [58] regarding the relationship of receptor numbers and hepatocyte mass in cases of portal vein embolization and specific surgical procedures. Using GSA data several authors [59] and an accurate assessment of postoperative receptor numbers tried to select patients for specific surgical procedures based on calculations of functional remnant receptor volume but Wakabaashi et al [60] disclosed that these estimates markedly changed after alterations of blood flow, making these assumptions inapplicable for the extent of liver disease or postoperative recovery. In due course there was a shift in receptor numbers towards the hyperplastic liver lobe after contralateral portal vein embolization as stated by Kubo et al [61].…”
Section: 399m-tc-galactosyi-human Serum Albumin Scintigraphymentioning
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