title: Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters.
abstract: BACKGROUND
  Accurate preoperative estimation of remnant liver function is critically important for hepatic surgery, and the expression of asialoglycoprotein receptors (ASGPR) is associated with hepatic function.
  
  
  METHODS
  Thirty-two patients with hepatocellular carcinoma who underwent surgical resection were studied. To estimate the expression of ASGPR in the remnant liver, simulated surgery was performed on fusion images that combined data from (99m)technetium-galactosyl human serum albumin ((99m)Tc-GSA)/single photon emission computed tomography (SPECT) and computed tomography (CT) scanning. The liver uptake ratio (LUR) of (99m)Tc-GSA and the functional liver volume (FLV) in the remnant liver were predicted and were compared with postoperative liver function parameters.
  
  
  RESULTS
  The LUR of (99m)Tc-GSA was strongly correlated with the extent of hepatic ASGPR expression (r = 0.944, p = 5.01 x 10(-16)), being confirmed to be a reliable parameter for the evaluation of liver function. The estimated remnant LUR, but not the estimated remnant FLV, was significantly correlated with postoperative liver function parameters, such as serum total bilirubin (r = -0.430, p < 0.05), prothrombin activity (r = 0.515, p < 0.01), and serum cholinesterase activity (r = 0.546, p < 0.01) at 1 week.
  
  
  CONCLUSIONS
  Preoperative estimation of the extent of ASGPR expression in the remnant liver on CT/GSA-SPECT fusion images correlated well with postoperative liver function parameters, suggesting its usefulness for surgical decisions.
authors: Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 66-8501, Japan.
authors: Yuji
authors: Y
authors: Iimuro
authors: Toru
authors: T
authors: Kashiwagi
authors: Junichi
authors: J
authors: Yamanaka
authors: Tadamichi
authors: T
authors: Hirano
authors: Shinichi
authors: S
authors: Saito
authors: Takaaki
authors: T
authors: Sugimoto
authors: Shinichiro
authors: S
authors: Watanabe
authors: Nobukazu
authors: N
authors: Kuroda
authors: Toshihiro
authors: T
authors: Okada
authors: Yasukane
authors: Y
authors: Asano
authors: Naoki
authors: N
authors: Uyama
authors: Jiro
authors: J
authors: Fujimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D037263:Asialoglycoprotein Receptor / Q000096:biosynthesis*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D013668:Technetium Tc 99m Aggregated Albumin / Q000493:pharmacokinetics; D016284:Technetium Tc 99m Pentetate / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D037263:Asialoglycoprotein Receptor; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate