title: Prediction of indocyanine green retention rate at 15 minutes by correlated liver function parameters before hepatectomy.
abstract: BACKGROUND
  Indocyanine green retention rate at 15 min (ICGR15) is a useful marker of liver function in deciding on the extent of hepatectomy. To determine ICGR15 regardless of liver condition, we sought to establish a formula for converted ICGR15 based on conventional blood tests and technetium-99 m galactosyl human serum albumin ((99m)Tc-GSA) scintigraphy.
  
  
  METHODS
  We measured liver function parameters, including ICGR15, in 307 patients, including 265 liver cancer patients without biliary obstruction (no obstruction group) and 42 with biliary obstruction (obstruction group).
  
  
  RESULTS
  In the no obstruction group, multiple regression analysis identified blood pool clearance ratio (HH15), liver uptake ratio (LHL15) calculated by heart and liver activity between 3 and 15 min after injection of (99m)Tc-GSA, and serum hyaluronic acid as significant correlates (P < 0.05). The calculated converted ICGR15 was then equal to 0.02∗HA + 0.276∗(HH15∗100)-0.501∗(LHL15∗100) + 41.41. The mean difference between actual and converted ICGR15 was significantly lower in the obstruction than in the no obstruction group (P = 0.031). A significantly larger proportion of patients of the obstruction group had lower converted ICGR15 than those of the no obstruction group (P = 0.045).
  
  
  CONCLUSIONS
  The converted ICGR15 is useful for evaluating hepatic function in patients with biliary obstruction who plan to undergo major hepatectomy.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Syuuichi
authors.initials: S
authors.lastname: Tobinaga
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Fukuoka
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
authors.forename: Takashi
authors.initials: T
authors.lastname: Kudo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D002779:Cholestasis / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green / Q000378:metabolism*; D008099:Liver / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012044:Regression Analysis; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors
chemical_list: 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