Prediction of postoperative decompensated liver function by technetium-99m galactosyl-human serum albumin liver scintigraphy in patients with hepatocellular carcinoma complicating chronic liver disease

Abstract

LHL15 was a reliable preoperative indicator of the risk of major postoperative complications in patients who had resection for HCC.

Relationship Between CT Volumetry and Functional Liver Volume Using Technetium-99m Galactosyl Serum Albumin Scintigraphy in Patients Undergoing Preoperative Portal Vein Embolization Before Major Hepatectomy: A Preliminary Study

“…Tests using 99m Tc-GSA scintigraphy, such as LHL15 (19,20), heart activity at 15 minutes by heart activity at 3 min (HH15) (20), modified receptor index determined by LHL15/HH15 (20), and maximal removal rate (Rmax) (11), are very reliable and noninvasive methods for evaluating hepatic functional reserve and do not require blood sampling. Asialoglycoprotein is exclusively internalized into hepatocytes by a receptor (10), and therefore, a decrease in the number of asialoglycoprotein receptors is specifically observed in injured livers (21).…”

“…Liver activity at 15 min (LHL15) by 99m Tc-GSA scintigraphy was compared with the ICGR15 and other functional liver parameters preoperatively (19). Lobectomy was performed in 6 patients, and extended lobectomy in 10 patients.…”

Relationship between indocyanine green test and technetium-99m galactosyl serum albumin scintigraphy in patients scheduled for hepatectomy: Clinical evaluation and patient outcome

“…A combination of the ICG clearance test and 99m Tc-GSA has been used as the standard liver tests prior to liver resection [10]. However, discrepancies between these tests are occasionally observed in patients with liver injury [8,12,13], which could lead to confusion about which result is the most reliable in pre-operative assessment of liver function. Furthermore, the result of the ICG clearance test is influenced by hepatic blood flow or hyperbilirubinemia [8,12,14].…”

Current status of hepatic resection for hepatocellular carcinoma

“…4 Liver scintigraphy with 99 m-galactosyl-human serum albumin allows an assessment of hepatic reserve based on the selective uptake by asialoglycoprotein receptors on hepatocytes, which can be performed even in icteric patients. 5 Galactose elimination capacity has also been reported to predict complications and survival after hepatic resection. 6 Of these studies, ICG R15 is the most frequently used determinant for the extent of hepatic resection and is utilized as follows: Ͻ15% for trisegmentectomy, Ͻ20% for lobectomy and anterior segmentectomy, Ͻ25% for posterior or medial segmentectomy, Ͻ30% for lateral segmentectomy, and Ͻ35% for subsegmentectomy or less.…”