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

作者：Nanashima Atsushi^*; Abo Takafumi; Kudo Takashi; Sakamoto Ichiro; Hayashi Hideyuki; Murakami Goushi; Takeshita Hiroaki; Hidaka Shigekazu; Kido Yasuo; Nagayasu Takeshi

来源：Nuclear Medicine Communications, 2013, 34(5): 478-488.

DOI：10.1097/MNM.0b013e32835f945f

• diseased liver
• functional liver volume
• hepatocellular carcinoma
• portal vein embolization
• technetium-99m galactosyl human serum albumin liver scintigraphy

Objectives The 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 (Tc-99m-GSA) scintigraphy. To this end, we examined the relationship using data from surgical records of 67 patients with hepatocellular carcinoma who underwent hepatectomy. %26lt;br%26gt;Materials and methods Liver functional parameters or functional volume was estimated by Tc-99m-GSA scintigraphy and computed tomography volumetry was used to estimate morphological volume. %26lt;br%26gt;Results Liver uptake ratio at 15 min (LHL15) was correlated with the indocyanine green retention rate at 15 min (ICGR15; R= -0.608, P %26lt; 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 %26lt; 0.01), functional volume was decreased in the diseased liver with portal vein tumor thrombus or portal vein embolization. By applying Tc-99m-GSA volumetry, portal pressure and alkaline phosphatase level were correlated with decreased volume of the embolized liver, and platelet count and cholesterol level were correlated with increased volume of the nonembolized liver (P %26lt; 0.05). By measuring functional volume, four patients who were functionally borderline on the basis of the ICGR15 test safely underwent scheduled major hepatectomy. %26lt;br%26gt;Conclusion Under 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.

• 出版日期2013-5