title: Usefulness of examining hepatic functional volume using technetium-99m galactosyl serum albumin scintigraphy in hepatocellular carcinoma.
abstract: OBJECTIVE
  The aim of the study was to clarify the clinical significance of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in terms of technetium-99m galactosyl human serum albumin (99mTc-GSA) scintigraphy. To this end, we examined the relationship using data from surgical records of 67 patients with hepatocellular carcinoma who underwent hepatectomy.
  
  
  METHODS
  Liver functional parameters or functional volume was estimated by 99mTc-GSA scintigraphy and computed tomography volumetry was used to estimate morphological volume.
  
  
  RESULTS
  Liver uptake ratio at 15 min (LHL15) was correlated with the indocyanine green retention rate at 15 min (ICGR15; R=-0.608, P<0.01); however, five patients (7.5%) had values outside this correlation. In these patients, LHL15 reflected clinical status and patient outcomes more. Although morphological and functional volumes were well correlated (P<0.01), functional volume was decreased in the diseased liver with portal vein tumor thrombus or portal vein embolization. By applying 99mTc-GSA volumetry, portal pressure and alkaline phosphatase level were correlated with decreased volume of the embolized liver, and platelet count and cholesterol level were correlated with increased volume of the nonembolized liver (P<0.05). By measuring functional volume, four patients who were functionally borderline on the basis of the ICGR15 test safely underwent scheduled major hepatectomy.
  
  
  CONCLUSIONS
  Under the ICGR15 test as the standard for preoperative hepatic function, auxiliary application of LHL15 and functional volumetry provides useful information on hepatocellular carcinoma patients undergoing hepatectomy.
authors: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
authors: Atsushi
authors: A
authors: Nanashima
authors: Takafumi
authors: T
authors: Abo
authors: Takashi
authors: T
authors: Kudo
authors: Ichiro
authors: I
authors: Sakamoto
authors: Hideyuki
authors: H
authors: Hayashi
authors: Goushi
authors: G
authors: Murakami
authors: Hiroaki
authors: H
authors: Takeshita
authors: Shigekazu
authors: S
authors: Hidaka
authors: Yasuo
authors: Y
authors: Kido
authors: Takeshi
authors: T
authors: Nagayasu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green / Q000378:metabolism; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009929:Organ Size; D049268:Positron-Emission Tomography; D016019:Survival Analysis; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D007208:Indocyanine Green; D016284:Technetium Tc 99m Pentetate