Evaluation of the Effect of Portal Vein Embolization on Liver Function by 99mTc-Galactosyl Human Serum Albumin Scintigraphy

Kubo, Shoji; Shiomi, Susumu; Tanaka, Hiromu; Shuto, Taichi; Takemura, Shigekazu; Mikami, Shinichi; Uenishi, Takahiro; Nishino, Yuki; Hirohashi, Kazuhiro; Kawamura, Etsushi; Kinoshita, Hiroaki

doi:10.1006/jsre.2002.6503

Cited by 22 publications

(10 citation statements)

References 19 publications

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“…3) [8][9][10]. These results indicated that PVE induces a shift in hepatic function from the embolized to the nonembolized part of the liver, PVE of the right portal vein increases the hepatic functional reserve and left liver volume, and 99m Tc-GSA uptake after PVE may predict the response to liver resection.…”

Section: Portal Vein Embolization Before Major Hepatectomymentioning

confidence: 81%

Portal Vein Embolization: History and Current Indications

et al. 2017

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Portal vein embolization (PVE) was first adapted for patients undergoing major hepatectomy for hepatocellular carcinoma (HCC). In these patients, PVE caused hypertrophy of the unaffected liver and increased the volumetric ratio of future liver remnant (FLR) to total liver volume. ^99mTechnetium-galactosyl human serum albumin (^99mTc-GSA) scintigraphy revealed that PVE also induced a shift in hepatic function from the embolized part to the nonembolized part of the liver. Various hepatobiliary malignancies can be treated using PVE, and PVE is increasingly being used to expand the indication for major hepatectomy in patients with initially insufficient FLR volume or function. The indication for PVE is determined by the underlying liver function and standardized FLR volume. In patients with chronic hepatitis, the histologic inflammatory activity was negatively correlated with the increase in FLR volume, and PVE is not suitable for patients with high serum 7s collagen concentrations (>8 ng/ml). This finding may predict the efficacy of PVE. PVE before major hepatectomy can act as a tolerance test to avoid postoperative hepatic failure. PVE also improved long-term survival after liver resection in patients with HCC. Presently, PVE is a safe and useful treatment for patients undergoing major hepatectomy.

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Section: Portal Vein Embolization Before Major Hepatectomymentioning

confidence: 81%

Portal Vein Embolization: History and Current Indications

et al. 2017

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“…The first is the timing of liver functional assessment. Previous modalities have assessed liver function in the preoperative period, while NIR fluorescence imaging in the present study offered the advantage of real-time assessment [5,6,21,23,24,25,26]. The second is that NIR fluorescence imaging, as in this study, could be used to assess liver function in each of the observed regions.…”

Section: Discussionmentioning

confidence: 92%

“…To prevent this lethal complication, thorough preoperative planning and careful patient selection are required. The Child-Pugh score, plasma retention rate of indocyanine green (ICG) at 15 min (ICGR15), plasma clearance rate of ICG (ICGK), technetium-99m galactosyl human serum albumin liver scintigraphy, and remnant liver volume have been employed as the main methods for assessing liver function prior to hepatectomy [2,3,4,5,6,7]. However, these conventional methods are incapable of evaluating liver function in each segment or specific regions of the liver.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Real-Time Assessment of Liver Function with Near-Infrared Fluorescence Imaging

Narasaki¹,

Noji²,

Wada³

et al. 2017

Eur Surg Res

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Background: Postoperative liver failure is a serious complication after major hepatectomy, and perioperative prediction of its incidence using current technology is still very difficult. Near-infrared (NIR) fluorescence imaging allows quantitative assessment of the fluorescent signal from indocyanine green (ICG) in regions of interest on the liver surface. This method might offer a new promising modality for evaluating regional liver reserve. However, data are lacking regarding the relationship between liver function and fluorescent signals on the liver surface after intravenous ICG injection. This study was conducted to obtain the data necessary to apply NIR fluorescence imaging as a modality for measuring liver function. Materials and Methods: This study included 16 patients who underwent open hepatopancreatobiliary surgery between March 2011 and March 2012. After laparotomy, ICG was injected intravenously at 2.5 mg/L of liver volume, then the fluorescence intensity (FI) and signal-to-background ratio (SBR) in the lateral segment of the liver were assessed for 15 min. Intraoperative blood samples were also obtained to measure the plasma clearance rate of ICG (ICGK). Correlations between ICGK, liver volume, and SBR, as well as between ICGK, liver volume, and rate of change of FI were analyzed. Results: The experimental procedure was performed in all 16 patients. The FI of the liver increased rapidly after ICG injection, then became more gradual, reaching a near-plateau after 15 min. A significant correlation was seen between ICGK and the rate of change of FI up to 15 min (|rS| = 0.5725, p < 0.05). Conclusion: This is the first report to show a relationship between liver function and fluorescent signals on the liver surface after intravenous ICG injection. Intraoperative NIR fluorescence imaging with ICG may be useful as a new method for assessing liver function.

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“…The FRL GSA index increased 30% on evaluation two weeks after PVE (10). Kawa et al reported that Rmax was more useful than the GSA index to evaluate liver function (11).…”

Section: Discussionmentioning

confidence: 97%