Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 8/2014

01-10-2014 | Original Article

Assessment of hepatic functional regeneration after hepatectomy using 99mTc-GSA SPECT/CT fused imaging

Authors: Morikatsu Yoshida, Shinya Shiraishi, Fumi Sakamoto, Toru Beppu, Daisuke Utsunomiya, Hirohisa Okabe, Seiji Tomiguchi, Hideo Baba, Yasuyuki Yamashita

Published in: Annals of Nuclear Medicine | Issue 8/2014

Login to get access

Abstract

Background

The liver itself regenerates after hepatectomy but little is known about how much hepatic function recovers during the regeneration. The liver uptake value (LUV), calculated from Tc-99m-labeled galactosyl-human-serum-albumin (99mTc-GSA) SPECT/CT fused images, is reliable and useful for evaluating hepatic function. In this study, we evaluated the clinical usefulness of LUV for estimating hepatic functional regeneration after hepatectomy.

Methods

We enrolled 95 patients who had undergone 99mTc-GSA SPECT/CT tests before/on days 30 and 90 after hepatectomy. We determined the LUV from the 99mTc-GSA SPECT/CT images and calculated the %LUV (postoperative LUV/preoperative LUV × 100). Based on surgical procedures and histopathological damage, we divided the study population into patients with severe (n = 12) or non-severe fibrosis (n = 33) who had undergone minor hepatectomy, and patients with severe (n = 14) or non-severe fibrosis (n = 36) having major hepatectomy. On the 90th post-hepatectomy day, five patients manifested liver failure; in these patients, we analyzed the co-relation between liver failure and the results of the liver function tests performed on day 30 after surgery.

Results

Although the %LUV reached 95.4 ± 12.2 % in 30 days, in patients with severe fibrosis after major hepatectomy it remained below 90 %. Patients having low %LUV (<75 %) and high serum bilirubin (>2.0 mg/dl) at 30 days showed a relative risk of liver failure of 12.0 and 4.5 (p < 0.001 and p < 0.001), respectively.

Conclusions

Although the %LUV recovered to about 95 % in all patients within 30 days after the hepatectomy, in patients with severe fibrosis having major hepatectomy, the process of recovery was delayed. The %LUV corresponded to the quality of the liver function which emerged in a later post-hepatectomy phase.
Literature
1.
de Graaf W, Vetelainen RL, de Bruin K, van Vliet AK, van Gulik TM, Bennink RJ. 99mTc-GSA scintigraphy with SPECT for assessment of hepatic function and functional volume during liver regeneration in a rat model of partial hepatectomy. J Nucl Med. 2008;49(1):122–8.PubMedCrossRef
2.
Henderson JM, Heymsfield SB, Horowitz J, Kutner MH. Measurement of liver and spleen volume by computed tomography. Assessment of reproducibility and changes found following a selective distal splenorenal shunt. Radiology. 1981;141(2):525–7.PubMedCrossRef
3.
Chen MF, Hwang TL, Hung CF. Human liver regeneration after major hepatectomy. A study of liver volume by computed tomography. Ann Surg. 1991;213(3):227–9.PubMedCrossRefPubMedCentral
4.
Breitenstein S, Apestegui C, Petrowsky H, Clavien PA. “State of the art” in liver resection and living donor liver transplantation: a worldwide survey of 100 liver centers. World J Surg. 2009;33(4):797–803.PubMedCrossRef
5.
de Graaf W, Bennink RJ, Vetelainen R, van Gulik TM. Nuclear imaging techniques for the assessment of hepatic function in liver surgery and transplantation. J Nucl Med. 2010;51(5):742–52.PubMedCrossRef
6.
Yamanaka N, Okamoto E, Kuwata K, Tanaka N. A multiple regression equation for prediction of posthepatectomy liver failure. Ann Surg. 1984;200(5):658–63.PubMedCrossRefPubMedCentral
7.
Kwon AH, Matsui Y, Ha-Kawa SK, Kamiyama Y. Functional hepatic volume measured by technetium-99m-galactosyl-human serum albumin liver scintigraphy: comparison between hepatocyte volume and liver volume by computed tomography. Am J Gastroenterol. 2001;96(2):541–6.PubMedCrossRef
8.
Okamoto E, Kyo A, Yamanaka N, Tanaka N, Kuwata K. Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. Surgery. 1984;95(5):586–92.PubMed
9.
Imamura H, Kawasaki S, Shiga J, Bandai Y, Sanjo K, Idezuki Y. Quantitative evaluation of parenchymal liver cell volume and total hepatocyte number in cirrhotic patients. Hepatology. 1991;14(3):448–53.PubMedCrossRef
10.
Beppu T, Hayashi H, Okabe H, Masuda T, Mima K, Otao R, et al. Liver functional volumetry for portal vein embolization using a newly developed 99mTc-galactosyl human serum albumin scintigraphy SPECT-computed tomography fusion system. J Gastroenterol. 2011;46(7):938–43.PubMedCrossRef
11.
Yumoto Y, Yagi T, Sato S, Nouso K, Kobayashi Y, Ohmoto M, et al. Preoperative estimation of remnant hepatic function using fusion images obtained by (99m)Tc-labelled galactosyl-human serum albumin liver scintigraphy and computed tomography. Br J Surg. 2010;97(6):934–44.PubMedCrossRef
12.
Kwon AH, Ha-Kawa SK, Uetsuji S, Kamiyama Y, Tanaka Y. Use of technetium 99m diethylenetriamine-pentaacetic acid-galactosyl-human serum albumin liver scintigraphy in the evaluation of preoperative and postoperative hepatic functional reserve for hepatectomy. Surgery. 1995;117(4):429–34.PubMedCrossRef
13.
Tanaka A, Shinohara H, Hatano E, Sato S, Kanazawa A, Yamaoka Y, et al. Perioperative changes in hepatic function as assessed by asialoglycoprotein receptor indices by technetium 99m galactosyl human serum albumin. Hepatogastroenterology. 1999;46(25):369–75.PubMed
14.
Yoshida M, Shiraishi S, Sakaguchi F, Utsunomiya D, Tashiro K, Tomiguchi S, et al. 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? Jpn J Radiol. 2012;30(3):255–62.PubMedCrossRef
15.
Yoshida M, Shiraishi S, Sakaguchi F, Utsunomiya D, Tashiro K, Tomiguchi S, et al. A quantitative index measured on (9)(9)mTc GSA SPECT/CT 3D fused images to evaluate severe fibrosis in patients with chronic liver disease. Jpn J Radiol. 2012;30(5):435–41.PubMedCrossRef
16.
Strasberg SM. Nomenclature of hepatic anatomy and resections: a review of the Brisbane 2000 system. J Hepatobiliary Pancreat Surg. 2005;12(5):351–5.PubMedCrossRef
17.
Ichida F, Tsuji T, Omata M, Ichida T, Inoue K, Kamimura T, et al. New Inuyama classification; new criteria for histological assessment of chronic hepatitis. Int Hepatol Commun. 1996;6(2):8.CrossRef
18.
Mitsumori A, Nagaya I, Kimoto S, Akaki S, Togami I, Takeda Y, et al. Preoperative evaluation of hepatic functional reserve following hepatectomy by technetium-99m galactosyl human serum albumin liver scintigraphy and computed tomography. Eur J Nucl Med. 1998;25(10):1377–82.PubMedCrossRef
19.
Utsunomiya D, Shiraishi S, Imuta M, Tomiguchi S, Kawanaka K, Morishita S, et al. Added value of SPECT/CT fusion in assessing suspected bone metastasis: comparison with scintigraphy alone and nonfused scintigraphy and CT. Radiology. 2006;238(1):264–71.PubMedCrossRef
20.
Jochum C, Beste M, Penndorf V, Farahani MS, Testa G, Nadalin S, et al. Quantitative liver function tests in donors and recipients of living donor liver transplantation. Liver Transpl. 2006;12(4):544–9.PubMedCrossRef
21.
Jansen PL, Chamuleau RA, van Leeuwen DJ, Schipper HG, Busemann-Sokole E, van der Heyde MN. Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors. Scand J Gastroenterol. 1990;25(2):112–8.PubMedCrossRef
22.
Kobayashi T, Imamura H, Aoki T, Sugawara Y, Kokudo N, Makuuchi M. Morphological regeneration and hepatic functional mass after right hemihepatectomy. Dig Surg. 2006;23(1–2):44–50.PubMedCrossRef
23.
Yildirim SI, Poulsen HE. Quantitative liver functions after 70% hepatectomy. Eur J Clin Invest. 1981;11(6):469–72.PubMedCrossRef
24.
Nagasue N, Yukaya H, Ogawa Y, Kohno H, Nakamura T. Human liver regeneration after major hepatic resection. A study of normal liver and livers with chronic hepatitis and cirrhosis. Ann Surg. 1987;206(1):30–9.PubMedCrossRefPubMedCentral
25.
de Graaf W, Bennink RJ, Heger M, Maas A, de Bruin K, van Gulik TM. Quantitative assessment of hepatic function during liver regeneration in a standardized rat model. J Nucl Med. 2011;52(2):294–302.PubMedCrossRef
26.
Bruix J, Castells A, Bosch J, Feu F, Fuster J, Garcia-Pagan JC, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology. 1996;111(4):1018–22.PubMedCrossRef
27.
Schindl MJ, Redhead DN, Fearon KC, Garden OJ, Wigmore SJ. The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut. 2005;54(2):289–96.PubMedCrossRefPubMedCentral
28.
Vauthey JN, Pawlik TM, Ribero D, Wu TT, Zorzi D, Hoff PM, et al. Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol. 2006;24(13):2065–72.PubMedCrossRef
29.
Otao R, Beppu T, Isiko T, Mima K, Okabe H, Hayashi H, et al. External biliary drainage and liver regeneration after major hepatectomy. Br J Surg. 2012;99(11):1569–74.PubMedCrossRef
Metadata
Title
Assessment of hepatic functional regeneration after hepatectomy using 99mTc-GSA SPECT/CT fused imaging
Authors
Morikatsu Yoshida
Shinya Shiraishi
Fumi Sakamoto
Toru Beppu
Daisuke Utsunomiya
Hirohisa Okabe
Seiji Tomiguchi
Hideo Baba
Yasuyuki Yamashita
Publication date
01-10-2014
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 8/2014
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-014-0872-3

Other articles of this Issue 8/2014

Annals of Nuclear Medicine 8/2014 Go to the issue

Original Article

Benefit of cardiac N-13 PET CFR for combined anatomical and functional diagnosis of ischemic coronary artery disease: a pilot study

Original Article

Simulation study on a stationary data acquisition SPECT system with multi-pinhole collimators attached to a triple-head gamma camera system

Original Article

Dual-phase 99mTc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism: correlation with clinical or pathological variables

Original Article

Comparison of 123I-MIBG myocardial scintigraphy, brain perfusion SPECT, and voxel-based MRI morphometry for distinguishing between dementia with Lewy bodies and Alzheimer’s disease

Original Article

Parathyroid dual tracer subtraction scintigraphy: small regions method for quantitative assessment of parathyroid adenoma uptake

Original Article

Accuracy of amplitude-based respiratory gating for PET/CT in irregular respirations