Usefulness of examining hepatic functional volume using technetium-99m galactosyl serum albumin scintigraphy in hepatocellular carcinoma

Abstract

ObjectivesThe aim of the study was to clarify the clinical significance of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in terms of technetium-99m galactosyl human serum albumin ( 99m Tc-GSA) scintigraphy. To this end, we examined the relationship using data from surgical records of 67 patients with hepatocellular carcinoma who underwent hepatectomy. Materials and methodsLiver functional parameters or functional volume was estimated by 99m Tc-GSA scintigraphy and computed tomography volumetry was used to estimate morphological volume. ResultsLiver uptake ratio at 15 min (LHL15) was correlated with the indocyanine green retention rate at 15 min (ICGR15; R=−0.608, P<0.01); however, five patients (7.5%) had values outside this correlation.In these patients, LHL15 reflected clinical status and patient outcomes more. Although morphological and functional volumes were well correlated (P<0.01), functional volume was decreased in the diseased liver with portal vein tumor thrombus or portal vein embolization. By applying ConclusionUnder the ICGR15 test as the standard for preoperative hepatic function, auxiliary application of LHL15 and functional volumetry provides useful information on hepatocellular carcinoma patients undergoing hepatectomy.

Correlation between morphological and functional liver volume in each sector using integrated SPECT/CT imaging by computed tomography and technetium-99m galactosyl serum albumin scintigraphy in patients with various diseases who had undergone hepatectomy

“…We demonstrated that for some patients with discrepancies and invasion to major vessels and patients undergoing PVE, we could obtain clinically good outcomes by applying functional volumetry. The relationship between the functional volumes and the conventional laboratory data was already reported in our previous reports (20,32), in which the functional volume was well correlated with other functional liver reserves or portal pressure but not with morphological CT volumetry in patients who underwent PVE. Thus, this useful method to aid in deciding operative indication should be spread worldwide.…”

Prediction of postoperative liver failure using gadoxetic acid‐enhanced magnetic resonance imaging in patients with hepatocellular carcinoma

“…Liver cirrhosis was present in 74 (61.2%) patients. Most had good reserved liver function with CTP class A in 119 patients (98.3%) and with low median MELD score of 8.0 (range, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Median ICGR 15 and AFP level were 7.1% (range, 0-68.8%) and 13.7 ng/mL (range, 0.8-4.8 × 10 4 ng/mL), respectively.…”

“…12,13 In addition, preoperative measurement of hepatic functional volume using technetium-99 mgalactosyl human serum albumin (99mTc-GSA) scintigraphy has been performed to predict PLF. 14,15 Recently, because of an improvement of magnetic resonance image (MRI) modality, it has been reported that quantitative measurement of liver function is possible with the liver-specific hepatocyte-directed MRI contrast agent, Gadoxetic acid (Primovist, Bayer-Schering, Berlin, Germany). [16][17][18] However, previous studies were limited because of small number of enrolled subjects, [16][17][18] retrospective database, 16,18 postoperative assessment, 17 or only enrollment of major resection with including patients with liver metastasis from colon cancer and excluding patients with liver cirrhosis.…”

Nuclear imaging methods for the prediction of postoperative morbidity and mortality in patients undergoing localized, liver-directed treatments: a systematic review

“…Five studies reported historical comparisons on the outcome rate of LF and mortality in the period before and [16,20,25], whereas the historical comparisons on the use of [ 99m Tc]Tc-GSA did not result in a significant decrease in the number of liver failure cases in the period after implementation of [ 99m Tc]Tc-GSA liver scintigraphy [56,58].…”