Relationship between CT volumetry and functional liver volume using technetium-99m galactosyl serum albumin scintigraphy in patients undergoing preoperative portal vein embolization before major hepatectomy: a preliminary study.
To clarify the relationship between morphological measurements of hepatic volume by computed tomography (CT-vol) and functional volume (RI-vol) by technetium-99m galactosyl human serum albumin (99mTc-GSA) scintigraphy, and its clinical significance, we examined 16 patients with a background liver status of either normal liver function (n=4), chronic hepatitis or cirrhosis (n=7), or obstructive jaundice (n=5). In five patients who underwent preoperative portal vein embolization (PVE), volumetric measurement was performed 2 weeks after PVE. The mean values of CT-vol and RI-vol of the right lobe were 692+/-147 cm3 (66.1+/-10.7%) and 668+/-159 cm3 (67.8+/-13.2%), respectively, and those of the left lobe were 329+/-138 cm3 (33.9+/-10.6%) and 328+/- 170 cm3 (32.2+/-13.2%), respectively. There were no significant differences in the volume measurements between the two volumetric techniques. Correlations between CT-vol and RI-vol in the right and left lobes were positive and significant (r=0.912 and 0.903, respectively; both P's<0.001). The mean values of post-PVE CT-vol and RI-vol of the right lobe in five patients were significantly different (628+/-149 and 456+/-211 cm3, respectively; P=0.033). However, the mean values of post-PVE CT-vol and RI-vol of the left lobe were not different (496+/-124 and 483+/-129 cm3, respectively). We propose that volumetric measurement by 99mTc-GSA scintigraphy is useful for detecting changes in functional volume of individual lobes of the liver and is a more dynamic method compared with detection of morphological changes by CT scan.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Yamaguchi
Hiroyuki
H
Shibasaki
Shinichi
S
Morino
Shigeyuki
S
Ide
Noboru
N
Takeshita
Hiroaki
H
Tsuji
Takashi
T
Sawai
Terumitsu
T
Nakagoe
Tohru
T
Nagayasu
Takeshi
T
Ogawa
Youji
Y
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000628:therapy; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000628:therapy; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000628:therapy; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007564:Japan; D008099:Liver / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011300:Preoperative Care; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin