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A quantitative index measured on 99mTc GSA SPECT/CT 3D fused images to evaluate severe fibrosis in patients with chronic liver disease

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Abstract

Purpose

We compared quantitative indices estimated by use of technetium-99m galactosyl human serum albumin (99mTc-GSA) single-photon emission computed tomography (SPECT)/computed tomography (CT) fused imaging and hepatic fibrosis in patients with chronic liver disease.

Materials and methods

On the basis of pathological findings we divided 161 patients into non-severe and severe fibrosis groups (n = 81 and n = 80, respectively). We measured 2 indices by 99mTc-GSA SPECT/CT fused imaging: liver uptake value (LUV) = [radioactivity (whole liver)/radioactivity (injected)] × 100/body surface area, and functional liver index (FLI) = [radioactivity (hepatocytes)/radioactivity (injected)] × 100/liver volume. We compared these indices with biochemical and histopathological results.

Results

Univariate and multivariate analyses showed that FLI, LUV, LHL15, and prothrombin time were significant independent predictors of severe fibrosis. On the basis of receiver operating characteristics analysis, the areas under curve values of FLI, LUV, LHL15, and prothrombin time for predicting severe fibrosis were 0.83, 0.73, 0.69, and 0.68, respectively. Using an FLI value of 0.053, it was possible to predict severe fibrosis with 65 % sensitivity, 88 % specificity, and 76 % accuracy.

Conclusion

Assessment of functional hepatocytes by use of 99mTc-GSA SPECT/CT fused images is useful for identifying pathological liver fibrosis.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Morikatsu Yoshida, Shinya Shiraishi, Fumi Sakaguchi, Daisuke Utsunomiya & Yasuyuki Yamashita

  2. Kumamoto City Hospital, Kumamoto, Japan

    Kuniyuki Tashiro

  3. Department of Diagnostic Medical Imaging, School of Health Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

    Seiji Tomiguchi

  4. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Hirohisa Okabe, Toru Beppu & Hideo Baba

  5. Department of Radiology, Kumamoto University, 1-1-1 Honjyo, Kumamoto, 860-8556, Japan

    Morikatsu Yoshida

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  1. Morikatsu Yoshida
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  2. Shinya Shiraishi
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Correspondence to Morikatsu Yoshida.

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Yoshida, M., Shiraishi, S., Sakaguchi, F. et al. A quantitative index measured on 99mTc GSA SPECT/CT 3D fused images to evaluate severe fibrosis in patients with chronic liver disease. Jpn J Radiol 30, 435–441 (2012). https://doi.org/10.1007/s11604-012-0072-9

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  • DOI: https://doi.org/10.1007/s11604-012-0072-9

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