99mTc-GSA SPECT/CT fusion imaging for hepatectomy candidates with extremely deteriorated ICG value

Sumiyoshi, Tatsuaki; Okabayashi, Takehiro; Negoro, Yuji; Hata, Yasuhiro; Noda, Yoshifumi; Sui, Kenta; Iwata, Jun; Matsumoto, Manabu

doi:10.1007/s11604-018-0753-0

Cited by 17 publications

(18 citation statements)

References 17 publications

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“…26 Because 99m Tc-GSA SPECT scintigraphy is affected neither by portal-systemic shunting nor jaundice, this imaging examination enables more accurate liver functional assessment in such conditions compared to the ICGR15 test. 27 Further study including 99m Tc-GSA SPECT scintigraphy would be required.…”

Section: Discussionmentioning

confidence: 99%

Volumetric Assessment and Clinical Predictor of Cirrhotic Livers With Normal Liver Function Undergoing Hepatectomy

Shioiri¹,

Aoki²,

Park³

et al. 2021

Preprint

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Aim: Indocyanine green retention rate at 15 minutes (ICGR15) is a frequently-used indicator of liver function. However, cirrhotic liver is sometimes observed intraoperatively despite a normal preoperative ICGR15 (<10 %). Herein, we conducted clinical and volumetric assessments of cirrhotic livers with normal ICGR15.Methods: Patients undergoing hepatectomy for hepatocellular carcinoma were divided into 3 groups: non-cirrhotic livers (Group A, n=112): cirrhotic livers with ICGR15 <10% (Group B, n=71): and cirrhotic livers with ICGR15 >10% (Group C, n=296). Background characteristics and surgical outcomes were compared between groups. Functional liver volume (FLV) was computed using total liver volume and signal intensity ratio. Liver parenchymal cell volume ratio was measured in non-cancerous tissue obtained from resected specimens. Univariate and multivariate analyses were performed to detect clinical characteristics correlating with cirrhotic liver pathology with normal ICGR15.Results: There was no significant difference between groups in TLV. FLV was gradually reduced from Group A toward Group C. Liver parenchymal cell volume ratio was also gradually reduced from Group A toward Group C. Multivariate analysis revealed that platelet count (<12 x104/mm3) (P = 0.001) and prothrombin time (<80 %) (P = 0.025) were significantly associated with cirrhotic liver pathology among patients with normal ICGR15.Conclusion: Our results suggested that cirrhotic liver pathology despite normal liver function was characterized by slightly decreasing liver parenchyma as well as slight degree of fibrosis. Platelet count and PT% are useful for predicting liver cirrhosis with normal ICGR15.

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Section: Discussionmentioning

confidence: 99%

Volumetric Assessment and Clinical Predictor of Cirrhotic Livers With Normal Liver Function Undergoing Hepatectomy

Shioiri¹,

Aoki²,

Park³

et al. 2021

Preprint

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“…This test allows for an indirect assessment of function and metabolic activity of hepatocytes. A low rate of galactose elimination may indicate a liver failure or other pathology [72,73].…”

Section: Clinical Methods For Assessing Functional and Structural Chamentioning

confidence: 99%

“…as established by Sumiyoshi et al [73], can be distorted by abnormal hepatic blood flow; this factor limits the method application in patients with intrahepatic shunts. The test is also not applicable for patients with excretory defects or jaundice.…”

Section: Reviewsmentioning

confidence: 99%

Modern Methods for Assessing the Regenerative Potential of the Liver after Partial Hepatectomy (Review)

Rodimova¹,

Kuznetsova²,

Bobrov³

et al. 2019

Sovrem Tehnol Med

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The review addresses the main methods for assessing the function and regenerative potential of the liver. They include both the traditional methods, commonly used in clinical practice, and the latest promising techniques suitable for the analysis of cellular and tissue pathology and having a proven diagnostic value.It is known that the dynamics of liver regeneration is reflected in the metabolic status of liver cells, their morphology, and the molecular rearrangement. Therefore, by looking at these parameters we will be able to assess the regenerative potential of the liver as a whole.At present, the most promising method is represented by multiphoton microscopy able to generate the second harmonic; there are also such techniques as coherent anti-stokes Raman spectroscopy (CARS), stimulated Raman scattering (SRS) microscopy, and fluorescence lifetime imaging microscopy (FLIM). In addition, a number of options for analyzing metabolic and structural changes are provided by mass spectrometry, in particular time-of-flight secondary ion mass spectrometry (ToF-SIMS). Studies using these methods with in vivo models and with human biopsy samples demonstrate their relevance in biomedical research and in clinical practice alike.

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“…The majority of the studies investigated both major and minor surgery. Four studies also included non-operative interventions such as radiofrequency ablation, transarterial embolization or chemoembolization, percutaneous ethanol injection, or microwave coagulation therapy [31,52,75,87]. The vast majority of trials reported on postoperative LF or mortality.…”

Section: Study Demographicsmentioning

confidence: 99%

Nuclear imaging methods for the prediction of postoperative morbidity and mortality in patients undergoing localized, liver-directed treatments: a systematic review

et al. 2020

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Background: Several nuclear imaging methods may predict postoperative liver function and outcome, but none has achieved recommendations in clinical guidelines. The purpose of this systematic review was to summarize the existing knowledge on this topic. Methods: MEDLINE and Web of Science were searched for studies investigating nuclear medicine imaging methods for the prediction of postoperative liver function in patients undergoing localized, liver-directed treatments. The postoperative endpoints were clinical outcome (morbidity and mortality) as well as measures of postoperative liver function, e.g., liver function assessed by biochemical tests or nuclear imaging. Results: A total of 1352 references were identified, of which 82 fulfilled the eligibility criteria and were included in the review. Most studies (n = 63) were retrospective studies. The vast majority of studies assessed [ 99m Tc]Tcgalactosyl serum albumin (GSA) (n = 57) and [ 99m Tc]Tc-mebrofenin (n = 19). Liver resection was entirely or partly major (involved at least three segments) in 78 reports. There were notable variations in the research methodology, e.g., image acquisition, imaging variables, and endpoints. Thirty-seven studies reported on postoperative mortality, of which most reported descriptive data at the patient level. Of the four reports that performed multivariate analyses, two showed significant predictive results of isotope-based preoperative tests. Fifty-two papers presented data on postoperative liver failure. Multivariate predictive analyses were performed in eighteen trials, of which fifteen showed the significant value of nuclear medicine tests. Conclusion: There is sparse evidence supporting the significant value of nuclear medicine imaging methods in predicting postoperative mortality. In contrast, a notable number of trials showed a significant prediction of liver failure in multivariate analyses. The research methodology was heterogeneous and exploratory in most trials. Documentation of nuclear medicine tests in this setting awaits the results of properly designed, prospective trials with the standardization of both the nuclear medicine test and endpoints.

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99mTc-GSA SPECT/CT fusion imaging for hepatectomy candidates with extremely deteriorated ICG value

Abstract: Tc-GSA SPECT/CT fusion imaging enables more accurate liver function assessment than the ICG test in patients with severely deteriorated ICG values.

Cited by 17 publications

References 17 publications

Volumetric Assessment and Clinical Predictor of Cirrhotic Livers With Normal Liver Function Undergoing Hepatectomy

Volumetric Assessment and Clinical Predictor of Cirrhotic Livers With Normal Liver Function Undergoing Hepatectomy

Modern Methods for Assessing the Regenerative Potential of the Liver after Partial Hepatectomy (Review)

Nuclear imaging methods for the prediction of postoperative morbidity and mortality in patients undergoing localized, liver-directed treatments: a systematic review

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