Usefulness of Tc-99m-GSA scintigraphy for liver surgery

Kaibori, Masaki; Ha-Kawa, Sang Kil; Maehara, Minoru; Ishizaki, Morihiko; Matsui, Kosuke; Sawada, Satoshi; Kwon, A‐Hon

doi:10.1007/s12149-011-0520-0

Cited by 30 publications

(21 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Asialoglycoprotein receptors on hepatocytes are characteristic of functional liver cells [45] , and liver scintigraphy using 99m Tc-galactosyl human serum albumin has been used as a reliable method of assessment of the hepatic functional reserve in hepatectomy and graft parenchymal function after LT [46][47][48] . There is a correlation between ICG clearance and the hepatic uptake ratio assayed by liver scintigraphy [45,46] .…”

Section: Strategic Value Of Icg Kinetics During Ltmentioning

confidence: 99%

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Hori

Ogura

Onishi

et al. 2016

WJH

View full text Add to dashboard Cite

Advanced liver cirrhosis is usually accompanied by portal hypertension. Long-term portal hypertension results in various vascular alterations. The systemic hemodynamic state in patients with cirrhosis is termed a hyperdynamic state. This peculiar hemodynamic state is characterized by an expanded blood volume, high cardiac output, and low total peripheral resistance. Vascular alterations do not disappear even long after liver transplantation (LT), and recipients with cirrhosis exhibit a persistent systemic hyperdynamic state even after LT. Stability of optimal systemic hemodynamics is indispensable for adequate portal venous flow (PVF) and successful LT, and reliable parameters for optimal systemic hemodynamics and adequate PVF are required. Even a subtle disorder in systemic hemodynamics is precisely indicated by the balance between cardiac output and blood volume. The indocyanine green (ICG) kinetics reflect the patient's functional hepatocytes and effective PVF, and PVF is a major determinant of the ICG elimination Hori T et al . Peculiar hemodynamics in advanced cirrhosis constant (k ICG) in the well-preserved allograft. The k ICG value is useful to set the optimal PVF during living-donor LT and to evaluate adequate PVF after LT. Perioperative management has a large influence on the postoperative course and outcome; therefore, key points and unexpected pitfalls for intensive management are herein summarized. Transplant physicians should fully understand the peculiar systemic hemodynamic behavior in LT recipients with cirrhosis and recognize the critical importance of PVF after LT.

show abstract

Section: Strategic Value Of Icg Kinetics During Ltmentioning

confidence: 99%

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Hori

Ogura

Onishi

et al. 2016

WJH

View full text Add to dashboard Cite

show abstract

“…Technetium-99m diethylenetriamine-penta-acetic acid-galactosyl human serum albumin ( 99m Tc-GSA) scintigraphy is one of the prevalent examinations performed for evaluation of liver functional reserve (17)(18)(19)(20)(21)(22)(23)(24)(25). Conventional indices of 99m Tc-GSA scintigraphy, namely the blood clearance index (HH15) and the receptor index (LHL15), use accumulation counts of only two time points.…”

Section: Introductionmentioning

confidence: 99%

Index of convexity: A novel method for assessing liver functional reserve using technetium-99m-galactosyl human serum albumin liver scintigraphy

Sato

Arita

Inoue

et al. 2017

BST

View full text Add to dashboard Cite

“…99m Tc-labeled diethylene triamine pentaacetate-galactosyl human serum albumin ( 99m Tc-GSA) is a radiopharmaceutical that binds specifically to the hepatic asialoglycoprotein receptor (ASGP-R). Expression of ASGP-R has been reported to be decreased in patients with chronic liver damage and thus it has been widely used to assess liver functional reserve in various pathological and pharmacological states (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

“…However, in patients with jaundice or when a porto-systemic shunt is present, the results of ICG15 are not reliable. In addition, discrepancies between ICG clearance and the extent of liver fibrosis are occasionally noted in such cases (8,12). ICG mainly reflected hepatic blood flow, while GSA was associated with both the amount of functional hepatocytes and blood flow (6,7,(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma

et al. 2014

View full text Add to dashboard Cite

Abstract. We aimed to examine the relationship between the preoperative GSA index [uptake ratio of the liver to the liver plus heart at 15 min (LHL15) to uptake ratio of the heart at 15 min to that at 3 min (HH15) ratio] calculated from 99m Tc-labeled diethylene triamine pentaacetate-galactosyl human serum albumin ( 99m Tc-GSA) scintigraphy and background liver fibrosis and to investigate whether the GSA index can be a useful predictor in hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) patients treated with surgical resection (SR). A total of 213 HCV-related HCC patients were analyzed. Receiver operating characteristic (ROC) curve analysis was performed for calculating the area under the ROC (AUROC) for nine noninvasive parameters including GSA index, indocyanine green retention at 15 min, aspartate aminotransferase (AST) to platelet ratio index, FIB-4 index, AST to alanine aminotransferase ratio, serum albumin, total bilirubin, platelet count and prothrombin time for cirrhosis. We also examined predictive factors associated with overall survival (OS) and recurrence-free survival (RFS) after SR in univariate and multivariate analyses. There were 153 males and 60 females with the mean age of 69.9 years. The median observation periods were 2.8 years. The mean maximum tumor size was 4.1 cm. HH15 ranged from 0.452 to 0.897. LHL15 ranged from 0.669 to 0.982. The mean value of the GSA index was 1.41. Among the nine parameters, the GSA index yielded the highest AUROC for cirrhosis with a level of 0.786 at an optimal cut-off value of 1.37 (sensitivity, 65.9%; specificity, 79.0%). In multivariate analyses, the GSA index was an independent predictor (P<0.001) linked to RFS and it had a marginal significance in terms of OS (P= 0.074). In conclusion, the preoperative GSA index can be a useful predictor in HCV-related HCC patients treated with SR. IntroductionHepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third most common cause of cancer-related death (1-3). In Japan, most HCC cases are due to chronic hepatitis C virus (HCV) infection (3). Curative therapies for HCC consist of liver transplantation, surgical resection (SR) and radiofrequency ablation (RFA) (1-3). The clinical outcome of HCC patients undergoing these therapies has improved substantially in recent years due to treatment advances. However, HCC often recurs even after curative therapies, leading to high mortality, and the pattern of HCC recurrence is frequently ectopic as well as local. The identification of predictive factors and effective management of HCC recurrence are essential for improving survival, even after curative treatment (1-5). Tc-labeled diethylene triamine pentaacetate-galactosyl human serum albumin ( 99m Tc-GSA) is a radiopharmaceutical that binds specifically to the hepatic asialoglycoprotein receptor (ASGP-R). Expression of ASGP-R has been reported to be decreased in patients with chronic liver damage and thus it has been widely used to assess liver functional reserve in various pathologica...

show abstract

Usefulness of Tc-99m-GSA scintigraphy for liver surgery

Cited by 30 publications

References 55 publications

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Index of convexity: A novel method for assessing liver functional reserve using technetium-99m-galactosyl human serum albumin liver scintigraphy

Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma

Contact Info

Product

Resources

About