Skip to main content
SpringerLink
Log in

Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background

Accurate preoperative estimation of remnant liver function is critically important for hepatic surgery, and the expression of asialoglycoprotein receptors (ASGPR) is associated with hepatic function.

Methods

Thirty-two patients with hepatocellular carcinoma who underwent surgical resection were studied. To estimate the expression of ASGPR in the remnant liver, simulated surgery was performed on fusion images that combined data from 99mtechnetium-galactosyl human serum albumin (99mTc-GSA)/single photon emission computed tomography (SPECT) and computed tomography (CT) scanning. The liver uptake ratio (LUR) of 99mTc-GSA and the functional liver volume (FLV) in the remnant liver were predicted and were compared with postoperative liver function parameters.

Results

The LUR of 99mTc-GSA was strongly correlated with the extent of hepatic ASGPR expression (r = 0.944, p = 5.01 × 10−16), being confirmed to be a reliable parameter for the evaluation of liver function. The estimated remnant LUR, but not the estimated remnant FLV, was significantly correlated with postoperative liver function parameters, such as serum total bilirubin (r = −0.430, p < 0.05), prothrombin activity (r = 0.515, p < 0.01), and serum cholinesterase activity (r = 0.546, p < 0.01) at 1 week.

Conclusion

Preoperative estimation of the extent of ASGPR expression in the remnant liver on CT/GSA-SPECT fusion images correlated well with postoperative liver function parameters, suggesting its usefulness for surgical decisions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Nagasue N, Kohno H, Chang YC, Taniura H, Yamanoi A, Uchida M, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg. 1993;217:375–84.

    Article  CAS  PubMed  Google Scholar 

  2. Imamura H, Sano K, Sugawara Y, Kokudo N, Makuuchi M. Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg. 2005;12:16–22.

    Article  PubMed  Google Scholar 

  3. Okamoto E, Kyo A, Yamanaka N, Tanaka N, Kuwata K. Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. Surgery. 1984;95:586–92.

    CAS  PubMed  Google Scholar 

  4. Truant S, Oberlin O, Sergent G, Lebuffe G, Gambiez L, Ernst O, et al. Remnant liver volume to body weight ratio > or = 0.5%: a new cut-off to estimate postoperative risks after extended resection in noncirrhotic liver. J Am Coll Surg. 2007;204:22–33.

    Article  PubMed  Google Scholar 

  5. Ashwell G, Morell AG. The role of surface carbohydrates in the hepatic recognition and transport of circulating glycoproteins. Adv Enzymol Relat Areas Mol Biol. 1974;41:99–128.

    CAS  PubMed  Google Scholar 

  6. Kubota Y, Kitagawa S, Inoue K, Ha-Kawa SK, Kojima M, Tanaka Y. Hepatic functional scintigraphic imaging with 99 mtechnetium galactosyl serum albumin. Hepatogastroenterology. 1993;40:32–6.

    CAS  PubMed  Google Scholar 

  7. Imaeda T, Kanematsu M, Asada S, Seki M, Doi H, Saji S. Utility of Tc-99 m GSA SPECT imaging in estimation of functional volume of liver segments in health and liver diseases. Clin Nucl Med. 1995;20:322–8.

    Article  CAS  PubMed  Google Scholar 

  8. Akaki S, Okumura Y, Sasai N, Sato S, Tsunoda M, Kuroda M, et al. Hepatectomy simulation discrepancy between radionuclide receptor imaging and CT volumetry: influence of decreased unilateral portal venous flow. Ann Nucl Med. 2003;17:23–9.

    Article  PubMed  Google Scholar 

  9. Yokoyama Y, Nagino M, Nishio H, Ebata T, Igami T, Nimura Y. Recent advances in the treatment of hilar cholangiocarcinoma: portal vein embolization. J Hepatobiliary Pancreat Surg. 2007;14:447–54.

    Article  PubMed  Google Scholar 

  10. Onodera Y, Takahashi K, Togashi T, Sugai Y, Tamaki N, Miyasaka K. Clinical assessment of hepatic functional reserve using 99mTc DTPA galactosyl human serum albumin SPECT to prognosticate chronic hepatic diseases—validation of the use of SPECT and a new indicator. Ann Nucl Med. 2003;17:181–8.

    Article  PubMed  Google Scholar 

  11. Kashiwagi T, Yutani K, Fukuchi M, Naruse H, Iwasaki T, Yokozuka K, et al. Correction of nonuniform attenuation and image fusion in SPECT imaging by means of separate X-ray CT. Ann Nucl Med. 2002;16:255–61.

    Article  PubMed  Google Scholar 

  12. Couinaud C. Surgical anatomy of the liver. Several new aspects. Chirurgie. 1986;112:337–42.

    CAS  PubMed  Google Scholar 

  13. IHPBA Ttcot. The Brisbane 2000 terminology of hepatic anatomy and resections. HPB. 2000; 2:333–9.

  14. Ha-Kawa SK, Tanaka Y, Hasebe S, Kuniyasu Y, Koizumi K, Ishii Y, et al. Compartmental analysis of asialoglycoprotein receptor scintigraphy for quantitative measurement of liver function: a multicentre study. Eur J Nucl Med. 1997;24:130–7.

    Article  CAS  PubMed  Google Scholar 

  15. Wu J, Ishikawa N, Takeda T, Tanaka Y, Pan XQ, Sato M, et al. The functional hepatic volume assessed by 99 mTc-GSA hepatic scintigraphy. Ann Nucl Med. 1995;9:229–35.

    Article  CAS  PubMed  Google Scholar 

  16. Sugahara K, Togashi H, Takahashi K, Onodera Y, Sanjo M, Misawa K, et al. Separate analysis of asialoglycoprotein receptors in the right and left hepatic lobes using Tc-GSA SPECT. Hepatology. 2003;38:1401–9.

    CAS  PubMed  Google Scholar 

  17. Iimuro Y, Nishio T, Morimoto T, Nitta T, Stefanovic B, Choi SK, et al. Delivery of matrix metalloproteinase-1 attenuates established liver fibrosis in the rat. Gastroenterology. 2003;124:445–58.

    Article  CAS  PubMed  Google Scholar 

  18. Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology. 1981;1:431–5.

    Article  CAS  PubMed  Google Scholar 

  19. Hwang EH, Taki J, Shuke N, Nakajima K, Kinuya S, Konishi S, et al. Preoperative assessment of residual hepatic functional reserve using 99mTc-DTPA-galactosyl-human serum albumin dynamic SPECT. J Nucl Med. 1999;40:1644–51.

    CAS  PubMed  Google Scholar 

  20. Satoh K, Yamamoto Y, Nishiyama Y, Wakabayashi H, Ohkawa M. 99mTc-GSA liver dynamic SPECT for the preoperative assessment of hepatectomy. Ann Nucl Med. 2003;17:61–7.

    Article  PubMed  Google Scholar 

  21. Shuke N, Okizaki A, Kino S, Sato J, Ishikawa Y, Zhao C, et al. Functional mapping of regional liver asialoglycoprotein receptor amount from single blood sample and SPECT. J Nucl Med. 2003;44:475–82.

    CAS  PubMed  Google Scholar 

  22. Takahashi Y, Murase K, Mochizuki T, Higashino H, Sugawara Y, Kinda A. A study on attenuation correction using Tc-99m external TCT source in Tc-99m GSA liver SPECT. Ann Nucl Med. 2004;18:585–90.

    Article  PubMed  Google Scholar 

  23. Kwon AH, Matsui Y, Kaibori M, Ha-Kawa SK. Preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin (GSA-Rmax) is useful for judging the safety of hepatic resection. Surgery. 2006;140:379–86.

    Article  PubMed  Google Scholar 

  24. Li XF, Taki J, Kinuya S, Higuchi T, Konishi S, Hwang EH, et al. Asialoglycoprotein receptor concentration in tumor-bearing livers and its fate early after their sectorial resection. Ann Nucl Med. 2003;17:489–93.

    Article  CAS  PubMed  Google Scholar 

  25. Kwon AH, Matsui Y, Kaibori M, Kamiyama Y. Functional hepatic regeneration following hepatectomy using galactosyl-human serum albumin liver scintigraphy. Transplant Proc. 2004;36:2257–60.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by Grant-in-Aid for Scientific Research (C) (No.20591560) from Japan Society for the Promotion of Science (JSPS) and “High-Tech Research Center” Project (No.06H025) from the Ministry of Education, Culture, Sports, Science and Technology (MEXT). The authors thank Miss Keiko Mitani for technical assistance.

Author information

Authors and Affiliations

  1. Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 66-8501, Japan

    Yuji Iimuro, Junichi Yamanaka, Tadamichi Hirano, Shinichi Saito, Takaaki Sugimoto, Nobukazu Kuroda, Toshihiro Okada, Yasukane Asano, Naoki Uyama & Jiro Fujimoto

  2. Nuclear Medicine and PET Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 66-8501, Japan

    Toru Kashiwagi & Shinichiro Watanabe

Authors
  1. Yuji Iimuro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Kashiwagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Junichi Yamanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tadamichi Hirano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shinichi Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takaaki Sugimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shinichiro Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nobukazu Kuroda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Toshihiro Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yasukane Asano
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Naoki Uyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jiro Fujimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jiro Fujimoto.

About this article

Cite this article

Iimuro, Y., Kashiwagi, T., Yamanaka, J. et al. Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters. J Hepatobiliary Pancreat Sci 17, 673–681 (2010). https://doi.org/10.1007/s00534-010-0264-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-010-0264-6

Keywords

Search

Navigation