Comparison of Tc-99m-GSA scintigraphy with hepatic fibrosis and regeneration in patients with hepatectomy

Abstract

Tc-99m-GSA scintigraphy is well correlated with liver fibrosis and may be useful for non-invasive, preoperative evaluations of liver fibrosis. The HH15 index, in particular, may be useful for predicting the rate of liver regeneration after hepatectomy.

Nuclear Imaging Techniques for the Assessment of Hepatic Function in Liver Surgery and Transplantation

“…99m Tc-GSA scintigraphy has also been used to preoperatively predict the rate of liver regeneration after partial hepatectomy in patients with liver fibrosis (58). 99m Tc-GSA scintigraphy correlates with the severity of liver fibrosis, and impaired liver regeneration is also described in patients with an increased severity of liver fibrosis (59).…”

“…99m Tc-GSA scintigraphy correlates with the severity of liver fibrosis, and impaired liver regeneration is also described in patients with an increased severity of liver fibrosis (59). Patients with a high preoperative HH15 (.0.52) that was due to fibrosis exhibited a worse regeneration of the remnant liver (58).…”

Preoperative evaluation using asialoscintigraphy in patients undergoing cardiac surgery with noncardiac liver cirrhosis

“…It was reported that HH15 is more useful than HLH15 for assessing the annual change in hepatic functional reserve 12 and for predicting liver regeneration after hepatectomy. 11 Similarly, in our patients, HH15 is more closely correlated with the indices of the ICG test than LHL15. Therefore, HH15, a blood clearance index, may be a practical and essential parameter in asialoscintigraphy.…”

“…It was reported that lower levels of HH15 were associated with posthepatectomy complications, suggesting the following cutoff lines: HH15 of 0.52 or 0.70 and LHL15 of 0.875 or 0.90. [9][10][11] Because the amount of our data is small, further studies are required to determine the cutoff values for risk prediction for cirrhotic patients undergoing cardiac surgery. We think that the cutoff values for asialoscintigraphy would help with risk stratification of cirrhotic patients, especially in those of Child-Pugh class A, where the hepatic functional reserve varies over a wide range.…”

“…In contrast, the results of asialoscintigraphy are not affected by the portal circulation and therefore uptake of 99m Tc-GSA is well correlated with the histopathological findings. 10,11 Asialoscintigraphy can be used to cover the pitfalls of the ICG test and therefore can evaluate liver function more accurately than the ICG test.…”