Liver fibrosis assessment using 99mTc-GSA SPECT/CT fusion imaging

  • Ryotaro Tokorodani
  • Tatsuaki SumiyoshiEmail author
  • Takehiro Okabayashi
  • Yasuhiro Hata
  • Yoshihiro Noda
  • Sojiro Morita
  • Hiromitsu Daisaki
  • Yukinori Okada
  • Eisuke Yasuda
Original Article



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.


Liver 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.

Ethical approval

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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Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  • Ryotaro Tokorodani
    • 1
    • 6
  • Tatsuaki Sumiyoshi
    • 2
    Email author
  • Takehiro Okabayashi
    • 2
  • Yasuhiro Hata
    • 3
  • Yoshihiro Noda
    • 3
  • Sojiro Morita
    • 3
  • Hiromitsu Daisaki
    • 4
  • Yukinori Okada
    • 5
  • Eisuke Yasuda
    • 6
  1. 1.Department of Radiological TechnologyKochi Health Sciences CenterKochiJapan
  2. 2.Department of Gastroenterological SurgeryKochi Health Sciences CenterKochiJapan
  3. 3.Department of RadiologyKochi Health Sciences CenterKochiJapan
  4. 4.Department of Gunma Prefectural College of Health SciencesMaebashiJapan
  5. 5.Department of RadiologySt. Marianna University School of MedicineKawasakiJapan
  6. 6.Department of Radiological Technology, Graduate School of Health ScienceSuzuka University of Medical ScienceSuzukaJapan

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