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Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 9/2018

01-09-2018 | Original Article

99mTc-GSA SPECT/CT fusion imaging for hepatectomy candidates with extremely deteriorated ICG value

Authors: Tatsuaki Sumiyoshi, Takehiro Okabayashi, Yuji Negoro, Yasuhiro Hata, Yoshihiro Noda, Kenta Sui, Jun Iwata, Manabu Matsumoto

Published in: Japanese Journal of Radiology | Issue 9/2018

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Abstract

Purpose

The value of indocyanine green (ICG) test is negatively affected in patients with intrahepatic shunt, ICG excretory defect, or jaundice. This study evaluated 99mTc-GSA SPECT/CT fusion imaging for assessing liver function in patients with severely deteriorated ICG values.

Materials and methods

Thirteen hepatectomy candidates with ICG retention rates over 40% were retrospectively analyzed. The ICG clearance rate (KICG) and estimated KICG obtained by 99mTc-GSA scintigraphy (KGSA) were used to evaluate preoperative whole liver function. Remnant liver function was assessed using the remnant (rem) KICG (= KICG × volumetric rate) and remKGSA (= KGSA × functional rate) indices; hepatectomy was considered unsafe for values < 0.05. The correlations of remKICG and remKGSA with postoperative mortality and morbidity were also investigated.

Results

KGSA values were significantly greater than KICG values (median: 0.12 vs. 0.059; p < 0.01); remKGSA values were greater than remKICG values in all patients (median: 0.107 vs. 0.0413; p < 0.01). Hepatectomy was considered unsafe in 70% patients using remKICG, and in none of those using remKGSA; liver failure or postoperative mortality did not occur.

Conclusions

99mTc-GSA SPECT/CT fusion imaging enables more accurate liver function assessment than the ICG test in patients with severely deteriorated ICG values.
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Metadata
Title
99mTc-GSA SPECT/CT fusion imaging for hepatectomy candidates with extremely deteriorated ICG value
Authors
Tatsuaki Sumiyoshi
Takehiro Okabayashi
Yuji Negoro
Yasuhiro Hata
Yoshihiro Noda
Kenta Sui
Jun Iwata
Manabu Matsumoto
Publication date
01-09-2018
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 9/2018
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-018-0753-0

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