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Annals of Surgical Oncology

, Volume 23, Issue 13, pp 4384–4391 | Cite as

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

  • Yukihiko Hiroshima
  • Kiyohiko Shuto
  • Kazuto Yamazaki
  • Daisuke Kawaguchi
  • Masatoshi Yamada
  • Yutaro Kikuchi
  • Kohei Kasahara
  • Takashi Murakami
  • Atsushi Hirano
  • Mikito Mori
  • Chihiro Kosugi
  • Kenichi Matsuo
  • Yasuo Ishida
  • Keiji Koda
  • Kuniya TanakaEmail author
Hepatobiliary Tumors

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.

Keywords

Fractal Dimension Irinotecan Oxaliplatin DTPA Portal Vein Embolization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

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

Disclosure

None.

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Yukihiko Hiroshima
    • 1
  • Kiyohiko Shuto
    • 1
  • Kazuto Yamazaki
    • 2
  • Daisuke Kawaguchi
    • 1
  • Masatoshi Yamada
    • 2
  • Yutaro Kikuchi
    • 1
  • Kohei Kasahara
    • 1
  • Takashi Murakami
    • 1
  • Atsushi Hirano
    • 1
  • Mikito Mori
    • 1
  • Chihiro Kosugi
    • 1
  • Kenichi Matsuo
    • 1
  • Yasuo Ishida
    • 2
  • Keiji Koda
    • 1
  • Kuniya Tanaka
    • 1
    Email author
  1. 1.Department of SurgeryTeikyo University Chiba Medical CenterIchiharaJapan
  2. 2.Department of PathologyTeikyo University Chiba Medical CenterIchiharaJapan

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