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Fused 99m-Tc-GSA SPECT/CT imaging for the preoperative evaluation of postoperative liver function: can the liver uptake index predict postoperative hepatic functional reserve?
MedLine Citation:
PMID:  22302293     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To evaluate the role of hepatic asialoglycoprotein receptor analysis in the preoperative estimation of postoperative hepatic functional reserve. METHODS: We obtained technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) SPECT/CT fusion images in 256 patients with liver disease scheduled for hepatic resection. The liver uptake value corrected for body surface area [LUV((BSA))] and liver uptake ratio (LUR) of the remnant were preoperatively estimated based on the fused images. These values were compared with the postoperative hepatic functional reserve. RESULTS: Significant correlations were observed between LUV((BSA)), LUR, and most conventional indicators of hepatic functional reserve. Postoperatively, nonpreserved liver functional reserve was observed in 15 of the 256 patients (5.8%). Remnant LUV((BSA)) showed better correlation than remnant LUR or the other indicators. No patients with remnant LUV((BSA)) above 28.0 manifested poor nonpreserved functional reserve. Using a LUV((BSA)) of 27.0, it was possible to predict postoperative poor hepatic functional reserve at a sensitivity of 91%, specificity of 81%, and accuracy of 81% postoperatively. According to multivariate analysis, a low remnant LUV((BSA)) was the only significant independent predictor of poor hepatic functional reserve. CONCLUSIONS: Our 99mTc-GSA SPECT/CT fusion imaging method was clinically useful for evaluating regional hepatic function and for predicting postoperative hepatic functional reserve.
Authors:
Morikatsu Yoshida; Shinya Shiraishi; Fumi Sakaguchi; Daisuke Utsunomiya; Kuniyuki Tashiro; Seiji Tomiguchi; Hirohisa Okabe; Toru Beppu; Hideo Baba; Yasuyuki Yamashita
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-3
Journal Detail:
Title:  Japanese journal of radiology     Volume:  -     ISSN:  1867-108X     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101490689     Medline TA:  Jpn J Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan, y_morikatsu@hotmail.com.
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