Liver functional volumetry for portal vein embolization using a newly developed 99mTc-galactosyl human serum albumin scintigraphy SPECT–computed tomography fusion system
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We developed a new combined 99mTc-galactosyl human serum albumin (GSA) scintigraphy single-photon emission computed tomography (SPECT)/CT system to evaluate the changes in functional liver volume with portal vein embolization (PVE).
We performed a prospective analysis of 25 patients treated with right PVE, and evaluated their functional liver volume perioperatively with a 99mTc-GSA scintigraphy SPECT–CT fusion system. The percentage of the non-tumorous remnant liver volume (%LV) and the percentage of functional remnant liver volume (%FLV) were estimated by using the following calculations: (future remnant volume − tumor volume)/(total liver volume − tumor volume) and functional future remnant liver volume/functional total liver volume, respectively.
Before PVE, the correlation was strongly significant between %LV and %FLV of the non-embolized liver, and the data were nearly equal (the regression coefficient was 1.005, P < 0.0001). In contrast, after PVE, there was a significant correlation between %LV and %FLV (P < 0.0001), but the regression coefficient was 1.192. The % LV increased significantly, from 38.1 to 52.0%, and the increment was 13.9% (P < 0.0005). The %FLV was also increased significantly, from 36.6 to 58.0%, and the increment was 21.4% (P < 0.0001). The increment was 7.5% greater for the %FLV compared to that of the %LV (P < 0.001).
The 99mTc-GSA scintigraphy SPECT–CT fusion system can estimate the correct functional liver volume and is useful in comparison with conventional CT volumetry.
KeywordsPortal vein embolization 99mTc-Galactosyl human serum albumin scintigraphy SPECT–computed tomography fusion system Functional liver volume
Portal vein embolization
Percentage of non-tumorous remnant liver volume
Percentage of functional remnant liver volume
Single-photon emission computed tomography
- 99mTc-GSA scintigraphy
99mTc-galactosyl human serum albumin scintigraphy
- LHL 15
Uptake ratio of the liver to the liver plus heart at 15 min
- ICG R15
Indocyanine green retention rate at 15 min
Conflict of interest
The authors declare that they have no conflicts of interest.
- 4.Yamanaka J, Saito S, Fujimoto J. Impact of preoperative planning using virtual segmental volumetry on liver resection for hepatocellular carcinoma. World J Surg. 2007;31:1249–55.Google Scholar
- 8.Beppu T, Iwatsuki M, Okabe H, Okabe K, Masuda T, Hayashi H, et al. A new approach to percutaneous transhepatic portal embolization using ethanolamine oleate iopamidol. J Gastroenterol. 2010;45:211–7. Epub 2009 Oct 10.Google Scholar
- 10.Kubo S, Shiomi S, Tanaka H, Shuto T, Takemura S, Mikami S et al. Evaluation of the effect of portal vein embolization on liver function by (99m) Tc-galactosyl human serum albumin scintigraphy. J Surg Res. 2002;107:113–8.Google Scholar
- 12.Nanashima A, Yamaguchi H, Shibasaki S, Morino S, Ide N, Takeshita H, et al. 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. Dig Dis Sci. 2006;51:1190–5.PubMedCrossRefGoogle Scholar
- 14.Okabe K, Beppu T, Masuda T, Hayashi H, Okabe H, Komori H et al. Portal vein embolization can prevent intrahepatic metastases to non-embolized liver. Hepatogastroenterology (in press).Google Scholar