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Fractal Dimension of Tc-99m DTPA GSA Estimates Pathologic Liver Injury due to Chemotherapy in Liver Cancer Patients

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Chemotherapy-induced liver injury after potent chemotherapy is a considerable problem in patients undergoing liver resection. The aim of this study was to assess the relationship between the fractal dimension (FD) of Tc-99m diethylenetriaminepentaacetic acid (DTPA) galactosyl human serum albumin (GSA) and pathologic change of liver parenchyma in liver cancer patients who have undergone chemotherapy.

Methods

We examined 34 patients (10 female and 24 male; mean age, 68.5 years) who underwent hepatectomy. Hepatic injury was defined as steatosis more than 30 %, grade 2–3 sinusoidal dilation, and/or steatohepatitis Kleiner score ≥4. Fractal analysis was applied to all images of Tc-99m DTPA GSA using a plug-in tool on ImageJ software (NIH, Bethesda, MD). A differential box-counting method was applied, and FD was calculated as a heterogeneity parameter. Correlations between FD and clinicopathological variables were examined.

Results

FD values of patients with steatosis and steatohepatitis were significantly higher than those without (P > .001 and P > .001, respectively). There was no difference between the FD values of patients with and without sinusoidal dilatation (P = .357). Multivariate logistic regression showed FD as the only significant predictor for steatosis (P = .005; OR 36.5; 95 % CI 3.0–446.3) and steatohepatitis (P = .012; OR, 29.1; 95 % CI 2.1–400.1).

Conclusions

FD of Tc-99m DTPA GSA was the significant predictor for fatty liver disease in patients who underwent chemotherapy. This new modality is able to differentiate steatohepatitis from steatosis; therefore, it may be useful for predicting chemotherapy-induced pathologic liver injury.

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Acknowledgment

This study was supported in part by JSPS KAKENHI (Grant 26830081 to Y.H. and Grant 24592009 to K.T.).

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Authors and Affiliations

  1. Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan

    Yukihiko Hiroshima MD, PhD, Kiyohiko Shuto MD, PhD, Daisuke Kawaguchi MD, Yutaro Kikuchi MD, Kohei Kasahara MD, Takashi Murakami MD, Atsushi Hirano MD, PhD, Mikito Mori MD, PhD, Chihiro Kosugi MD, PhD, Kenichi Matsuo MD, PhD, Keiji Koda MD, PhD & Kuniya Tanaka MD, PhD

  2. Department of Pathology, Teikyo University Chiba Medical Center, Ichihara, Japan

    Kazuto Yamazaki MD, PhD, Masatoshi Yamada MD, PhD & Yasuo Ishida MD, PhD

Authors
  1. Yukihiko Hiroshima MD, PhD
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  2. Kiyohiko Shuto MD, PhD
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  15. Kuniya Tanaka MD, PhD
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Correspondence to Kuniya Tanaka MD, PhD.

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Hiroshima, Y., Shuto, K., Yamazaki, K. et al. Fractal Dimension of Tc-99m DTPA GSA Estimates Pathologic Liver Injury due to Chemotherapy in Liver Cancer Patients. Ann Surg Oncol 23, 4384–4391 (2016). https://doi.org/10.1245/s10434-016-5441-7

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  • DOI: https://doi.org/10.1245/s10434-016-5441-7

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