Preoperative assessment of hepatic function: Utility of a new convenient two-compartment model analysis using galactosyl human serum albumin scintigraphy.
OBJECTIVE
Preoperative hepatic function was evaluated using technetium-99 m-diethylenetriaminepenta-acetic acid-galactosyl-human serum albumin (Tc-GSA) and a scintillation camera to detect hepatic Tc-GSA uptake by the asialoglycoprotein receptor.


METHODS
Sixty-two preoperative patients with liver cancer, including hepatocellular and cholangiocellular carcinomas, were studied, using two-parameter two-compartment model analysis. This model is simpler than either the three- or five-compartment model, both of which are accurate but which require complicated analysis and enormous calculation. The parameters k1 and k2 represented the transfer rate constant from the blood to the liver and from the liver to the blood, respectively. We calculated k1, k2, and k1/k2 from time-radioactivity curves of the heart and liver as well as VLmg, which represented the maximal amount of Tc-GSA in the liver.


RESULTS
The results were compared to those of conventional liver function analysis using Tc-GSA (the index of blood clearance (HH15) and the receptor index (LHL15)) or indocyanine green (ICGR15). Both HH15 and LHL15 were significantly correlated with k1, k1/k2, and VLmg. In addition, they closely correlated with the results of ICGR15 and some serum hepatic function tests (aspartate aminotransferase, choline esterase, albumin, platelet). The pathological grading for liver cirrhosis also correlated with k1, k1/k2, and VLmg. From a clinical point of view, VLmg had a significant correlation with the Child-Pugh score.


CONCLUSIONS
These results suggest that this new compartment analysis will be useful in evaluating liver function, as it is accurate, simple and convenient.
Kinoshita
Koichi
K
Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan. koichikinoshita@yahoo.co.jp
Ukikusa
Minoru
M
Iwaisako
Keiko
K
Arimoto
Akira
A
Fujisawa
Noriyoshi
N
Ozaki
Takeshi
T
Tanaka
Hironori
H
Seo
Satoshi
S
Naitoh
Masato
M
Nomura
Akinari
A
Inomoto
Takuya
T
Kitai
Toshiyuki
T
Ino
Keiichi
K
Higashiyama
Hiroshi
H
Hanafusa
Tetsuji
T
Nakajima
Yasuo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012709:Serum Albumin; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate
D019275:Radiopharmaceuticals; D012709:Serum Albumin; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D007208:Indocyanine Green; D016284:Technetium Tc 99m Pentetate