99mTc-DTPA-galactosyl-human-serum-albumin liver scintigraphy for evaluating hepatic functional reserve before hepatectomy in a patient with indocyanine green excretory defect: report of a case.
A 78-year-old woman with indocyanine green (ICG) excretory defect underwent left hepatectomy for cystadenocarcinoma. The retention rate of ICG at 15 min (ICGR(15)) was high, at 79.3%, despite all other liver function tests showing normal values. Conversely, 99mTc-DTPA-galactosyl-human-serum-albumin (GSA) liver scintigraphy showed a reduced accumulation of GSA in the left lateral lobe, the hepatic uptake ratio of the GSA scintigraphy was 0.96, and the arterial ketone body ratio was 1.67. Based on these results, we judged that the hepatic functional reserve of this patient was adequate for left hepatectomy, which was subsequently performed uneventfully. Histopathological examination of the resected liver showed neither fibrosis nor inflammatory cell infiltration. Thus, we consider that GSA liver scintigraphy is the best diagnostic modality for evaluating hepatic functional reserve in a patient with ICG excretory defect.
Kadono
Jun
J
Second Department of Surgery, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Kumemura
Hizuru
H
Nishida
Seigo
S
Nakamura
Noboru
N
Gejima
Kentaro
K
Nakajo
Masayuki
M
Tsuchimochi
Shinsaku
S
Matsumoto
Jun
J
Hamada
Nobuo
N
Sakata
Ryuzo
R
D000368:Aged; D004396:Coloring Agents; D003536:Cystadenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate
D004396:Coloring Agents; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D007208:Indocyanine Green; D016284:Technetium Tc 99m Pentetate