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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2015

01-04-2015 | Hepatobiliary Tumors

Using Dynamic 99mTc-GSA SPECT/CT Fusion Images for Hepatectomy Planning and Postoperative Liver Failure Prediction

Authors: Yilei Mao, MD, Shunda Du, MD, Jiantao Ba, MB, Fang Li, MD, Huayu Yang, MD, Xin Lu, MD, Xinting Sang, MD, Shaohua Li, MD, Lu Che, MD, Junxiang Tong, MD, Yiyao Xu, MD, Haifeng Xu, MD, Haitao Zhao, MD, Tianyi Chi, MD, Fang Liu, BN, Yanrong Du, MD, Xianzhong Zhang, CD, Xuebin Wang, CD, Jiahong Dong, MD, Shouxian Zhong, MD, Jiefu Huang, MD, Yongming Yu, MD, Jiping Wang, MD

Published in: Annals of Surgical Oncology | Issue 4/2015

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Abstract

Background

Available tools in liver surgery planning rely on the future remnant liver (FRL) volume. Inappropriate decision might be made since the same FRL volume might represent different liver functions depending on the severity of underlying liver damage. This study developed an alternative system to estimate FRL function and to predict the risk of postoperative liver failure.

Methods

Current study recruited 71 prehepatectomy patients and 71 healthy volunteers. A technetium-99-labelled asialoglycoproteins was given to participants and SPECT was used to capture the intensity of the signal, represented by uptake index (UI). The agreement between preoperative UI values, liver function tests, and Child scores were evaluated. Linear regression was used to evaluate the agreement between predicted UI for FRL and postoperative UI values. Area under the receiver operating characteristic (AUC) curve was used to evaluate the discriminative performance of UI in differentiating patient with high risk of liver failure.

Results

Preoperative UIs are highly correlated with Child score (P < 0.0001), especially to identify patients with ascites and elevated bilirubin. The predicted UIs were in close agreement with the actual postoperative UI values (r = 0.95 P < 0.001). The AUC analysis indicated that UI values had a high accuracy in predicting the risk of liver failure (AUC = 0.95, P < 0.0001). The best cut-off point was 0.9 and the corresponding sensitivity was 100 % and specificity was 92 %.

Conclusions

The new methodology reliably estimates FRL function and predicts the risk of liver failure. It provides a visual aid for liver surgeon in surgery planning and risk assessment.
Appendix
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Metadata
Title
Using Dynamic 99mTc-GSA SPECT/CT Fusion Images for Hepatectomy Planning and Postoperative Liver Failure Prediction
Authors
Yilei Mao, MD
Shunda Du, MD
Jiantao Ba, MB
Fang Li, MD
Huayu Yang, MD
Xin Lu, MD
Xinting Sang, MD
Shaohua Li, MD
Lu Che, MD
Junxiang Tong, MD
Yiyao Xu, MD
Haifeng Xu, MD
Haitao Zhao, MD
Tianyi Chi, MD
Fang Liu, BN
Yanrong Du, MD
Xianzhong Zhang, CD
Xuebin Wang, CD
Jiahong Dong, MD
Shouxian Zhong, MD
Jiefu Huang, MD
Yongming Yu, MD
Jiping Wang, MD
Publication date
01-04-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4117-4

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