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99mTc-GSA SPECT/CT fusion imaging for hepatectomy candidates with extremely deteriorated ICG value

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

The value of indocyanine green (ICG) test is negatively affected in patients with intrahepatic shunt, ICG excretory defect, or jaundice. This study evaluated 99mTc-GSA SPECT/CT fusion imaging for assessing liver function in patients with severely deteriorated ICG values.

Materials and methods

Thirteen hepatectomy candidates with ICG retention rates over 40% were retrospectively analyzed. The ICG clearance rate (KICG) and estimated KICG obtained by 99mTc-GSA scintigraphy (KGSA) were used to evaluate preoperative whole liver function. Remnant liver function was assessed using the remnant (rem) KICG (= KICG × volumetric rate) and remKGSA (= KGSA × functional rate) indices; hepatectomy was considered unsafe for values < 0.05. The correlations of remKICG and remKGSA with postoperative mortality and morbidity were also investigated.

Results

KGSA values were significantly greater than KICG values (median: 0.12 vs. 0.059; p < 0.01); remKGSA values were greater than remKICG values in all patients (median: 0.107 vs. 0.0413; p < 0.01). Hepatectomy was considered unsafe in 70% patients using remKICG, and in none of those using remKGSA; liver failure or postoperative mortality did not occur.

Conclusions

99mTc-GSA SPECT/CT fusion imaging enables more accurate liver function assessment than the ICG test in patients with severely deteriorated ICG values.

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Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi, Japan

    Tatsuaki Sumiyoshi, Takehiro Okabayashi & Kenta Sui

  2. Department of Medical Oncology, Kochi Health Sciences Center, Kochi, Japan

    Yuji Negoro

  3. Department of Radiology, Kochi Health Sciences Center, Kochi, Japan

    Yasuhiro Hata & Yoshihiro Noda

  4. Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi, Japan

    Jun Iwata & Manabu Matsumoto

Authors
  1. Tatsuaki Sumiyoshi
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  2. Takehiro Okabayashi
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  3. Yuji Negoro
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  4. Yasuhiro Hata
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  5. Yoshihiro Noda
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  6. Kenta Sui
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  7. Jun Iwata
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  8. Manabu Matsumoto
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Corresponding author

Correspondence to Tatsuaki Sumiyoshi.

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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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Sumiyoshi, T., Okabayashi, T., Negoro, Y. et al. 99mTc-GSA SPECT/CT fusion imaging for hepatectomy candidates with extremely deteriorated ICG value. Jpn J Radiol 36, 537–543 (2018). https://doi.org/10.1007/s11604-018-0753-0

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  • DOI: https://doi.org/10.1007/s11604-018-0753-0

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