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

• Published in: Annals of nuclear medicine 2010-12, Vol.24 (10), p.729-734
• Main Authors: Wakamatsu, Hideyuki, Nagamachi, Shigeki, Kiyohara, Shogo, Fujita, Seigo, Kamimura, Kiyohisa, Futami, Shigemi, Nishii, Ryuichi, Nagano, Motoaki, Kondou, Kazuhiro, Kai, Masahiro, Chijiiwa, Kazuo, Tamura, Shozo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Hepatectomy; Humans; Imaging; Liver - diagnostic imaging; Liver - pathology; Liver - physiopathology; Liver - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Organ Size; Original Article; Predictive Value of Tests; Radiology; Recovery of Function; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Pentetate; Time Factors; Tomography, Emission-Computed, Single-Photon - methods; Tomography, X-Ray Computed
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-010-0426-2

Objective Predicting liver functional reserve is important before partial hepatectomy. However, it is difficult to predict using morphologic imaging modalities, such as CT and MRI. In this study, we assess the usefulness of galactosyl human serum albumin (GSA) scintigraphy in predicting liver function recovery. Methods We performed 99m Tc-GSA scintigraphy before operation in 56 patients. Each patient was administered 185 MBq of 99m Tc-GSA by intravenous injection. Serial images were taken immediately after the administration for 40 min. SPECT images were obtained to make a functional map. We calculated the functioning parameter residual GSA-Rmax (GSA-RL) using analysis software developed by Dr. N. Shuke. In addition, we compared GSA-RL with the morphological parameter residual liver volume (RLV-CT) calculated by conventional CT and serum albumin (Alb) or cholinesterase (ChE). We analyzed the correlation between imaging parameters and the postoperative recovery periods of serum albumin (r-Alb) and cholinesterase (r-ChE) and the values at 1 and 3 months for serum albumin (1M-Alb, 3M-Alb) and cholinesterase (1M-ChE, 3M-ChE). Results We found significant correlations between GSA-RL and r-Alb, r-ChE, 1M-Alb, 3M-Alb, 1M-ChE and 3M-ChE, but not between RLV-CT and the same parameters. Conclusion The GSA-RL calculated by 99m Tc GSA-SPECT was a useful parameter for predicting postoperative liver function recovery that should be implemented before partial hepatectomy.