title: Three-Dimensional Quantitative Evaluation of the Segmental Functional Reserve in the Cirrhotic Liver Using Multi-Modality Imaging.
abstract: To quantitatively evaluate the regional functional reserve in the cirrhotic liver and to seek related index that reflects diminished segmental liver function. A 3D system for quantitative evaluation of the liver was used to fuse technetium-99m galactosyl human serum albumin single-photon emission computed tomography and computed tomography images from 20 patients with cirrhotic liver and hepatocellular carcinoma. A set of parameters reflecting liver function including morphological liver volume, functional liver volume, functional liver density (FLD), and the drug absorption rate constant for hepatic cells (GSA-K) was calculated. Differences in FLD and GSA-K in intrahepatic segments were compared in patients with a tumor embolus (Group Y) and those without such an embolus (Group N) in the right portal vein. Differences in FLD and GSA-K in tumor-bearing (T+ group) and tumor-free (T- group) segments in patients with no tumor embolus (Group N) were also compared. Eleven living donor liver transplantation donor served as the control group. The FLD of the liver as a whole was significantly lower in patients with cirrhosis than in the control group (0.53 ± 0.13 vs 0.68 ± 0.10, P = 0.010). The FLD in segments of the right hemiliver was significantly lower than that in segments of the left hemiliver in Group Y (0.31 ± 0.21 vs 0.58 ± 0.12, P = 0.002) but not in Group N (0.60 ± 0.19 vs 0.55 ± 0.13, P = 0.294). FLD was 0.45 ± 0.17 in the T+ group and 0.60 ± 0.08 in the T- group (P = 0.008). Differences in GSA-K in intrahepatic segments were not significant. In the control group, differences in FLD and GSA-K in intrahepatic segments were not significant. The segmental liver functional reserve can be quantitatively calculated. FLD, but not GSA-K, is an index that reflects diminished regional liver function caused by portal flow obstruction or tumor compression.
authors.affiliation: From the Center for Hepatopanreatobiliary Diseases (CX, XH, LG, AL, JD), Beijing Tsinghua Changguang Hospital, Tsinghua University Medical Center, Changping District, Beijing; Hospital & Institute of Hepato-Biliary Surgery (CX, WD, JD, AZ), Chinese PLA General Hospital, Haidian District, Beijing; and Department of Nuclear Medicine (YC, MS, CL), Chinese PLA General Hospital, Haidian District, Beijing, China.
authors.forename: Canhong
authors.initials: C
authors.lastname: Xiang
authors.forename: Yingmao
authors.initials: Y
authors.lastname: Chen
authors.forename: Mingzhe
authors.initials: M
authors.lastname: Shao
authors.forename: Can
authors.initials: C
authors.lastname: Li
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.forename: Lei
authors.initials: L
authors.lastname: Gong
authors.forename: Ang
authors.initials: A
authors.lastname: Li
authors.forename: Weidong
authors.initials: W
authors.lastname: Duan
authors.forename: Aiqun
authors.initials: A
authors.lastname: Zhang
authors.forename: Jiahong
authors.initials: J
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000473:pathology / Q000503:physiopathology; D008113:Liver Neoplasms / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009929:Organ Size; D011169:Portal Vein / Q000503:physiopathology; D019275:Radiopharmaceuticals / Q000494:pharmacology; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D013668:Technetium Tc 99m Aggregated Albumin / Q000494:pharmacology; D016284:Technetium Tc 99m Pentetate / Q000494:pharmacology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate