title: Liver functional volumetry for portal vein embolization using a newly developed 99mTc-galactosyl human serum albumin scintigraphy SPECT-computed tomography fusion system.
abstract: BACKGROUND
  We developed a new combined (99m)Tc-galactosyl human serum albumin (GSA) scintigraphy single-photon emission computed tomography (SPECT)/CT system to evaluate the changes in functional liver volume with portal vein embolization (PVE).
  
  
  METHODS
  We performed a prospective analysis of 25 patients treated with right PVE, and evaluated their functional liver volume perioperatively with a (99m)Tc-GSA scintigraphy SPECT-CT fusion system. The percentage of the non-tumorous remnant liver volume (%LV) and the percentage of functional remnant liver volume (%FLV) were estimated by using the following calculations: (future remnant volume - tumor volume)/(total liver volume - tumor volume) and functional future remnant liver volume/functional total liver volume, respectively.
  
  
  RESULTS
  Before PVE, the correlation was strongly significant between %LV and %FLV of the non-embolized liver, and the data were nearly equal (the regression coefficient was 1.005, P < 0.0001). In contrast, after PVE, there was a significant correlation between %LV and %FLV (P < 0.0001), but the regression coefficient was 1.192. The % LV increased significantly, from 38.1 to 52.0%, and the increment was 13.9% (P < 0.0005). The %FLV was also increased significantly, from 36.6 to 58.0%, and the increment was 21.4% (P < 0.0001). The increment was 7.5% greater for the %FLV compared to that of the %LV (P < 0.001).
  
  
  CONCLUSIONS
  The (99m)Tc-GSA scintigraphy SPECT-CT fusion system can estimate the correct functional liver volume and is useful in comparison with conventional CT volumetry.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Kosuke
authors.initials: K
authors.lastname: Mima
authors.forename: Ryu
authors.initials: R
authors.lastname: Otao
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Doi
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Morikatsu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Shinya
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011169:Portal Vein; D011446:Prospective Studies; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate