Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma

Nishikawa, Hiroki; Osaki, Yukio; Komekado, Hideyuki; Sakamoto, Azusa; Saito, Sumio; Nishijima, Norihiro; Nasu, Akihiro; Arimoto, Akira; Kita, Ryuichi; Kimura, Tōru

doi:10.3892/or.2014.3691

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…On the other hand, we previously reported that the GSA index as defined by the uptake ratio of the liver to the liver plus heart at 15 min to the uptake ratio of the heart at 15 min to that at 3 min ratio calculated from 99mTc-labeled diethylene triamine pentaacetate-galactosyl human serum albumin (99mTc-GSA) scintigraphy yielded the highest area under the receiver operating curve (AUROC) for predicting histologically proven cirrhosis with a level of 0.786 at an optimal cut-off value of 1.37 (sensitivity: 65.9%; specificity: 79.0%) in HCV-related HCC patient treated with surgical resection (SR) ( n = 213) and it can be a useful predictor for HCC recurrence after surgery [ 32 ]. Furthermore, in non-B and non-C HCC patients treated with SR ( n = 118), we have shown that the FIB-4 index yielded the highest AUROC for histologically proven cirrhosis with a level of 0.887 at an optimal cut-off value of 2.97 (sensitivity: 92.3%; specificity: 69.6%), and FIB-4 index >2.97 ( P = 0.044) was a significant independent factor linked to HCC recurrence [ 33 ].…”

Section: Noninvasive Methods For Predicting Lc or Lc Related Complmentioning

confidence: 99%

Liver Cirrhosis: Evaluation, Nutritional Status, and Prognosis

Nishikawa

Osaki

2015

Mediators of Inflammation

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The liver is the major organ for the metabolism of three major nutrients: protein, fat, and carbohydrate. Chronic hepatitis C virus infection is the major cause of chronic liver disease. Liver cirrhosis (LC) results from different mechanisms of liver injury that lead to necroinflammation and fibrosis. LC has been seen to be not a single disease entity but one that can be graded into distinct clinical stages related to clinical outcome. Several noninvasive methods have been developed for assessing liver fibrosis and these methods have been used for predicting prognosis in patients with LC. On the other hand, subjects with LC often have protein-energy malnutrition (PEM) and poor physical activity. These conditions often result in sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictive factors for poorer survival in patients with LC. Based on these backgrounds, several methods for evaluating nutritional status in patients with chronic liver disease have been developed and they have been preferably used in the clinical field practice. In this review, we will summarize the current knowledge in the field of LC from the viewpoints of diagnostic method, nutritional status, and clinical outcomes.

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Section: Noninvasive Methods For Predicting Lc or Lc Related Complmentioning

confidence: 99%

Liver Cirrhosis: Evaluation, Nutritional Status, and Prognosis

Nishikawa

Osaki

2015

Mediators of Inflammation

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“…Two papers compared survival rates in patients with liver function uptake values above or below a certain level (reported in the same column). Nishikawa et al [60] found a significant difference between survival rates in patients above and below a certain cut-off, whereas Yano et al [89] did not. Moreover, Rassam et al [67] did not find a significant association between 90-day mortality and the preoperative FLR function or uptake rate of [ 99m Tc]Tc-mebrofenin.…”

Section: Prediction Of Postoperative Mortalitymentioning

confidence: 96%

“…Kim et al [39] found LHL15 to be a significant predictor of overall complications, including mortality, in multivariate analysis. Nishikawa et al [60] found the GSA index to be a significant predictor of recurrence-free survival and overall survival in univariate analysis and documented a significant predictive value of the GSA index for recurrence-free survival in multivariate cox regression analysis (hazard ratio (HR) 2.4, p < 0.001). However, Yano et al [89] found that the GSA-R max parameters were not associated with overall survival or tumor-free survival in multivariate cox regression analysis, and Yamao et al [87] did not find a significant association between LHL15 and overall survival in univariate cox regression analysis.…”

Section: Prediction Of Postoperative Mortalitymentioning

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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