title: Hepatic clearance measured with (99m)Tc-GSA single-photon emission computed tomography to estimate liver fibrosis.
abstract: OBJECTIVE
  To evaluate the clinical utility of hepatic clearance (HC) measured with technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl human serum albumin ((99m)Tc-GSA) single-photon emission computed tomography (SPECT) to estimate the degree of liver fibrosis.
  
  
  METHODS
  Seventy-eight consecutive patients who underwent initial hepatectomy due to hepatocellular carcinoma were enrolled in this study. Indocyanine green clearance (ICG R15), quantitative indices estimated by (99m)Tc-GSA [the receptor index (LHL15 and HH15) and HC via SPECT analysis], and conventional liver function tests were performed before hepatectomy. Correlations among the quantitative indices for liver functional reserve, conventional liver function tests, and the degree of liver fibrosis were evaluated.
  
  
  RESULTS
  The degree of liver fibrosis was correlated with ICG R15, HH15, LHL15, and HC. HC showed the best correlation with conventional liver function tests. According to multivariate analysis, HC and LHL15 were significant independent predictors of severe fibrosis. HC was the most valuable index for predicting severe fibrosis.
  
  
  CONCLUSIONS
  HC measured with (99m)Tc-GSA SPECT is a reliable index for assessing liver fibrosis before hepatectomy.
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Taniguchi
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Atsutaka
authors.initials: A
authors.lastname: Okizaki
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Imai
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Einama
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Shuke
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Miyokawa
authors.affiliation: Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Furukawa
mesh_terms: D000368:Aged; D019540:Area Under Curve; D005260:Female; D005456:Fluorescent Dyes; D006498:Hepatectomy; D065669:Hepatobiliary Elimination; D006801:Humans; D007208:Indocyanine Green; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013668:Technetium Tc 99m Aggregated Albumin / Q000493:pharmacokinetics; D016284:Technetium Tc 99m Pentetate / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005456:Fluorescent Dyes; 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
keywords: Fibrosis; Hepatic clearance; Liver resection; Single-photon emission computed tomography; Technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl human serum albumin