Estimation of post-therapeutic liver reserve capacity using 99mTc-GSA scintigraphy prior to carbon-ion radiotherapy for liver tumors

Abstract

diethylenetriaminepentaacetic acid; GSA-RL, GSA-Rmax of the estimated residual liver; GSA-Rmax, maximal removal rate of 99m Tc -GSA; SPECT, single-photon emission computed tomography; 99m Tc-GSA, 99m Tc-galactosyl human serum albumin; VOI, volume of interest Key results:The median GSA-RL was 0.393 [range, 0.057-0.729] mg/min, GSA-Rmax after CIRT was 0.369 [range, 0.037-0.780] mg/min (P = .40).The linear regression equation representing the relationship between the GSA-RL and GSA-Rmax after CIRT was y = 0.05 + 0.84x (R 2 = 0.67, P < .0001). There was a positive correlation between the estimated and actual post-treatment values as well as in the group with impaired liver reserve (R 2 = 0.62, P = .0005).A summary statement: 99m Tc-GSA scintigraphy can be used to accurately estimate liver reserve capacity after carbon-ion radiotherapy in patients with liver tumors regardless of disease severity.Results: Overall, 50 patients were included (mean age ± standard deviation, 73 years ± 11; range, 29-89 years, 35 men). The median GSA-RL was 0.393 [range, 0.057-0.729] mg/min, the median GSA-Rmax after CIRT was 0.369 [range, 0.037-0.780] mg/min (P = .40). The linear regression equation representing the relationship between the GSA-RL and GSA-Rmax after CIRT was y = 0.05 + 0.84x (R 2 = 0.67, P < .0001). There was a positive correlation between the estimated and actual post-treatment values for all patients, as well as in the group with impaired liver reserve capacity (y = -0.02 + 1.09x (R 2 = 0.62, P = .0005)).Conclusions: 99m Tc-GSA scintigraphy has potential clinical utility for estimating the residual liver reserve capacity in patients undergoing carbon-ion radiotherapy for liver tumors. Clinical Trial registration: UMIN000038328, https://center6.umin.ac.jp/cgi-openbin/ctr/ctr_view.cgi?recptno=R000043545

Utility of quantitative analysis of 99mTc-GSA SPECT/CT in the evaluation of liver fibrosis: comparison with conventional assessment on planar images and its complementary diagnostic value with other liver function indices

“…99m Tc-GSA scintigraphy combined with SPECT and CT has been used to evaluate various liver diseases [18,23,26,27]. In this study, LUR was used as an indicator of liver brosis because it is reproducible and easy to calculate.…”

Utility of quantitative assessment of Tc-99m-diethylenetriamine-penta-acetic acid-galactosyl human serum albumin SPECT/CT in the identification of severe liver fibrosis: its complementary diagnostic value with other liver function indices

“…99m Tc-GSA SPECT/CT has been used to evaluate liver function prior to hepatectomy for various liver tumors, including cholangiocarcinoma and hepatocellular carcinoma [18,23,26,27]. An advantage of 99m Tc-GSA SPECT over planar imaging is the ability to assess regional liver function.…”

Evaluation of liver functionality after liver stereotactic body radiation therapy (SBRT) using blood tests and imaging examinations

“…Theoretically, it is considered a local treatment for liver cancer, similar to liver resection. Therefore, it can be used as a pretreatment evaluation method for SBRT, in addition to the preoperative indocyanine green retention test 15 minutes (ICG-R15) and galactosyl human serum albumin (GSA) scintigraphy [6,7,8,9,10,11,12,13]. In the case of liver resection, deterioration of liver function is observed at the time of surgery using blood tests (ALBI, GSA, and ICG-R15).…”

“…In recent years, the number of reports on the usefulness of re-irradiation has increased. We believe that a variety of modalities can be used to plan re-irradiation, as determined based on liver imaging and blood tests [6,8,10,11].…”