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Journal of Hepato-Biliary-Pancreatic Sciences

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01-09-2010 | Original article

Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/^99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters

Authors: Yuji Iimuro, Toru Kashiwagi, Junichi Yamanaka, Tadamichi Hirano, Shinichi Saito, Takaaki Sugimoto, Shinichiro Watanabe, Nobukazu Kuroda, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Jiro Fujimoto

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 5/2010

Abstract

Background

Accurate preoperative estimation of remnant liver function is critically important for hepatic surgery, and the expression of asialoglycoprotein receptors (ASGPR) is associated with hepatic function.

Methods

Thirty-two patients with hepatocellular carcinoma who underwent surgical resection were studied. To estimate the expression of ASGPR in the remnant liver, simulated surgery was performed on fusion images that combined data from ^99mtechnetium-galactosyl human serum albumin (^99mTc-GSA)/single photon emission computed tomography (SPECT) and computed tomography (CT) scanning. The liver uptake ratio (LUR) of ^99mTc-GSA and the functional liver volume (FLV) in the remnant liver were predicted and were compared with postoperative liver function parameters.

Results

The LUR of ^99mTc-GSA was strongly correlated with the extent of hepatic ASGPR expression (r = 0.944, p = 5.01 × 10⁻¹⁶), being confirmed to be a reliable parameter for the evaluation of liver function. The estimated remnant LUR, but not the estimated remnant FLV, was significantly correlated with postoperative liver function parameters, such as serum total bilirubin (r = −0.430, p < 0.05), prothrombin activity (r = 0.515, p < 0.01), and serum cholinesterase activity (r = 0.546, p < 0.01) at 1 week.

Conclusion

Preoperative estimation of the extent of ASGPR expression in the remnant liver on CT/GSA-SPECT fusion images correlated well with postoperative liver function parameters, suggesting its usefulness for surgical decisions.

Nagasue N, Kohno H, Chang YC, Taniura H, Yamanoi A, Uchida M, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg. 1993;217:375–84.CrossRefPubMed

Imamura H, Sano K, Sugawara Y, Kokudo N, Makuuchi M. Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg. 2005;12:16–22.CrossRefPubMed

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;95:586–92.PubMed

Truant S, Oberlin O, Sergent G, Lebuffe G, Gambiez L, Ernst O, et al. Remnant liver volume to body weight ratio > or = 0.5%: a new cut-off to estimate postoperative risks after extended resection in noncirrhotic liver. J Am Coll Surg. 2007;204:22–33.CrossRefPubMed

Ashwell G, Morell AG. The role of surface carbohydrates in the hepatic recognition and transport of circulating glycoproteins. Adv Enzymol Relat Areas Mol Biol. 1974;41:99–128.PubMed

Kubota Y, Kitagawa S, Inoue K, Ha-Kawa SK, Kojima M, Tanaka Y. Hepatic functional scintigraphic imaging with 99 mtechnetium galactosyl serum albumin. Hepatogastroenterology. 1993;40:32–6.PubMed

Imaeda T, Kanematsu M, Asada S, Seki M, Doi H, Saji S. Utility of Tc-99 m GSA SPECT imaging in estimation of functional volume of liver segments in health and liver diseases. Clin Nucl Med. 1995;20:322–8.CrossRefPubMed

Akaki S, Okumura Y, Sasai N, Sato S, Tsunoda M, Kuroda M, et al. Hepatectomy simulation discrepancy between radionuclide receptor imaging and CT volumetry: influence of decreased unilateral portal venous flow. Ann Nucl Med. 2003;17:23–9.CrossRefPubMed

Yokoyama Y, Nagino M, Nishio H, Ebata T, Igami T, Nimura Y. Recent advances in the treatment of hilar cholangiocarcinoma: portal vein embolization. J Hepatobiliary Pancreat Surg. 2007;14:447–54.CrossRefPubMed

10.

Onodera Y, Takahashi K, Togashi T, Sugai Y, Tamaki N, Miyasaka K. Clinical assessment of hepatic functional reserve using ^99mTc DTPA galactosyl human serum albumin SPECT to prognosticate chronic hepatic diseases—validation of the use of SPECT and a new indicator. Ann Nucl Med. 2003;17:181–8.CrossRefPubMed

11.

Kashiwagi T, Yutani K, Fukuchi M, Naruse H, Iwasaki T, Yokozuka K, et al. Correction of nonuniform attenuation and image fusion in SPECT imaging by means of separate X-ray CT. Ann Nucl Med. 2002;16:255–61.CrossRefPubMed

12.

Couinaud C. Surgical anatomy of the liver. Several new aspects. Chirurgie. 1986;112:337–42.PubMed

13.

IHPBA Ttcot. The Brisbane 2000 terminology of hepatic anatomy and resections. HPB. 2000; 2:333–9.

14.

Ha-Kawa SK, Tanaka Y, Hasebe S, Kuniyasu Y, Koizumi K, Ishii Y, et al. Compartmental analysis of asialoglycoprotein receptor scintigraphy for quantitative measurement of liver function: a multicentre study. Eur J Nucl Med. 1997;24:130–7.CrossRefPubMed

15.

Wu J, Ishikawa N, Takeda T, Tanaka Y, Pan XQ, Sato M, et al. The functional hepatic volume assessed by 99 mTc-GSA hepatic scintigraphy. Ann Nucl Med. 1995;9:229–35.CrossRefPubMed

16.

Sugahara K, Togashi H, Takahashi K, Onodera Y, Sanjo M, Misawa K, et al. Separate analysis of asialoglycoprotein receptors in the right and left hepatic lobes using Tc-GSA SPECT. Hepatology. 2003;38:1401–9.PubMed

17.

Iimuro Y, Nishio T, Morimoto T, Nitta T, Stefanovic B, Choi SK, et al. Delivery of matrix metalloproteinase-1 attenuates established liver fibrosis in the rat. Gastroenterology. 2003;124:445–58.CrossRefPubMed

18.

Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology. 1981;1:431–5.CrossRefPubMed

19.

Hwang EH, Taki J, Shuke N, Nakajima K, Kinuya S, Konishi S, et al. Preoperative assessment of residual hepatic functional reserve using ^99mTc-DTPA-galactosyl-human serum albumin dynamic SPECT. J Nucl Med. 1999;40:1644–51.PubMed

20.

Satoh K, Yamamoto Y, Nishiyama Y, Wakabayashi H, Ohkawa M. 99mTc-GSA liver dynamic SPECT for the preoperative assessment of hepatectomy. Ann Nucl Med. 2003;17:61–7.CrossRefPubMed

21.

Shuke N, Okizaki A, Kino S, Sato J, Ishikawa Y, Zhao C, et al. Functional mapping of regional liver asialoglycoprotein receptor amount from single blood sample and SPECT. J Nucl Med. 2003;44:475–82.PubMed

22.

Takahashi Y, Murase K, Mochizuki T, Higashino H, Sugawara Y, Kinda A. A study on attenuation correction using Tc-99m external TCT source in Tc-99m GSA liver SPECT. Ann Nucl Med. 2004;18:585–90.CrossRefPubMed

23.

Kwon AH, Matsui Y, Kaibori M, Ha-Kawa SK. Preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin (GSA-Rmax) is useful for judging the safety of hepatic resection. Surgery. 2006;140:379–86.CrossRefPubMed

24.

Li XF, Taki J, Kinuya S, Higuchi T, Konishi S, Hwang EH, et al. Asialoglycoprotein receptor concentration in tumor-bearing livers and its fate early after their sectorial resection. Ann Nucl Med. 2003;17:489–93.CrossRefPubMed

25.

Kwon AH, Matsui Y, Kaibori M, Kamiyama Y. Functional hepatic regeneration following hepatectomy using galactosyl-human serum albumin liver scintigraphy. Transplant Proc. 2004;36:2257–60.CrossRefPubMed

Title: Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters
Authors: Yuji Iimuro
Toru Kashiwagi
Junichi Yamanaka
Tadamichi Hirano
Shinichi Saito
Takaaki Sugimoto
Shinichiro Watanabe
Nobukazu Kuroda
Toshihiro Okada
Yasukane Asano
Naoki Uyama
Jiro Fujimoto
Publication date: 01-09-2010
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 5/2010
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-010-0264-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/^99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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