Assessment of hepatic functional regeneration after hepatectomy using (99m)Tc-GSA SPECT/CT fused imaging.

Abstract:

BACKGROUND:The liver itself regenerates after hepatectomy but little is known about how much hepatic function recovers during the regeneration. The liver uptake value (LUV), calculated from Tc-99m-labeled galactosyl-human-serum-albumin ((99m)Tc-GSA) SPECT/CT fused images, is reliable and useful for evaluating hepatic function. In this study, we evaluated the clinical usefulness of LUV for estimating hepatic functional regeneration after hepatectomy. METHODS:We enrolled 95 patients who had undergone (99m)Tc-GSA SPECT/CT tests before/on days 30 and 90 after hepatectomy. We determined the LUV from the (99m)Tc-GSA SPECT/CT images and calculated the %LUV (postoperative LUV/preoperative LUV × 100). Based on surgical procedures and histopathological damage, we divided the study population into patients with severe (n = 12) or non-severe fibrosis (n = 33) who had undergone minor hepatectomy, and patients with severe (n = 14) or non-severe fibrosis (n = 36) having major hepatectomy. On the 90th post-hepatectomy day, five patients manifested liver failure; in these patients, we analyzed the co-relation between liver failure and the results of the liver function tests performed on day 30 after surgery. RESULTS:Although the %LUV reached 95.4 ± 12.2 % in 30 days, in patients with severe fibrosis after major hepatectomy it remained below 90 %. Patients having low %LUV (<75 %) and high serum bilirubin (>2.0 mg/dl) at 30 days showed a relative risk of liver failure of 12.0 and 4.5 (p < 0.001 and p < 0.001), respectively. CONCLUSIONS:Although the %LUV recovered to about 95 % in all patients within 30 days after the hepatectomy, in patients with severe fibrosis having major hepatectomy, the process of recovery was delayed. The %LUV corresponded to the quality of the liver function which emerged in a later post-hepatectomy phase.

journal_name

Ann Nucl Med

authors

Yoshida M,Shiraishi S,Sakamoto F,Beppu T,Utsunomiya D,Okabe H,Tomiguchi S,Baba H,Yamashita Y

doi

10.1007/s12149-014-0872-3

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

780-8

issue

8

eissn

0914-7187

issn

1864-6433

journal_volume

28

pub_type

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