title: Monitoring of Total and Regional Liver Function after SIRT.
abstract: Selective internal radiation therapy (SIRT) is a promising treatment modality for advanced hepatocellular carcinoma or metastatic liver cancer. SIRT is usually well tolerated. However, in most patients, SIRT will result in a (temporary) decreased liver function. Occasionally patients develop radioembolization-induced liver disease (REILD). In case of a high tumor burden of the liver, it could be beneficial to perform SIRT in two sessions enabling the primary untreated liver segments to guarantee liver function until function in the treated segments has recovered or functional hypertrophy has occurred. Clinically used liver function tests provide evidence of only one of the many liver functions, though all of them lack the possibility of assessment of segmental (regional) liver function. Hepatobiliary scintigraphy (HBS) has been validated as a tool to assess total and regional liver function in liver surgery. It is also used to assess segmental liver function before and after portal vein embolization. HBS is considered as a valuable quantitative liver function test enabling assessment of segmental liver function recovery after regional intervention and determination of future remnant liver function. We present two cases in which HBS was used to monitor total and regional liver function in a patient after repeated whole liver SIRT complicated with REILD and a patient treated unilaterally without complications.
authors: Department of Nuclear Medicine, Academic Medical Center , Amsterdam , Netherlands.
authors: Roelof J
authors: RJ
authors: Bennink
authors: Department of Surgery, Academic Medical Center , Amsterdam , Netherlands.
authors: Kasia P
authors: KP
authors: Cieslak
authors: Department of Radiology, Academic Medical Center , Amsterdam , Netherlands.
authors: Otto M
authors: OM
authors: van Delden
authors: Department of Radiology, Academic Medical Center , Amsterdam , Netherlands.
authors: Krijn P
authors: KP
authors: van Lienden
authors: Department of Medical Oncology, Academic Medical Center , Amsterdam , Netherlands.
authors: Heinz-Josef
authors: HJ
authors: Klümpen
authors: Department of Hepatology, Academic Medical Center , Amsterdam , Netherlands.
authors: Peter L
authors: PL
authors: Jansen
authors: Department of Surgery, Academic Medical Center , Amsterdam , Netherlands.
authors: Thomas M
authors: TM
authors: van Gulik
keywords: SPECT/CT; hepatobiliary imaging; hepatocellular carcinoma; liver function; radionuclide imaging; selective internal radiation therapy