Liver fibrosis assessment using 99mTc-GSA SPECT/CT fusion imaging
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To determine the utility of mean standardized uptake value (SUVmean) of whole liver measured by 99mTc-GSA SPECT/CT fusion imaging, for evaluation of liver fibrosis.
Materials and methods
Eighty-six patients who underwent hepatectomy were enrolled, and were classified into the non-fibrosis or fibrosis group based on the pathological findings in the resected liver specimen. Univariate and multivariate analyses were performed between the two groups on four blood biochemical indices (albumin, total bilirubin, platelet count, and prothrombin time activity) and two 99mTc-GSA scintigraphy-derived liver function indices (LHL15 and SUVmean) to evaluate the independent predictive value for severe fibrosis. The diagnostic value of the index for severe fibrosis was assessed by calculating the area under the receiver operating characteristic curve.
Multivariate analysis showed that prothrombin time activity [odds ratio (OR) 0.519], LHL15 (OR 0.513), and SUVmean (OR 0.168) significantly correlated with liver fibrosis. SUVmean showed the largest area under the curve, with value of 0.804, 0.730 for platelet count, 0.717 for LHL15, and 0.668 for prothrombin time activity. The optimal cut-off value for SUVmean was 6.7, which yielded 62.9% sensitivity and 96.9% specificity.
SUVmean measured by 99mTc-GSA SPECT/CT fusion imaging enables highly accurate prediction of severe liver fibrosis.
KeywordsLiver fibrosis Tc-99m-diethylenetriamine-penta-acetic acid-galactosyl human serum albumin single-photon-emission computed tomography Standardized uptake value
We received no financial support.
Compliance with ethical standards
Conflict of interest
We have no conflict of interest to declare.
All procedures performed in studies involving human participants were in accordance with the ethics committee of the Kochi Health Sciences Center and with the 1964 Helsinki declaration. The study was approved by the institutional review board of Kochi Health Sciences Center, with a waiver of informed consent.
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