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Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/ 99m Tc‐GSA SPECT fusion images correlates well with postoperative liver function parameters
Author(s) -
Iimuro Yuji,
Kashiwagi Toru,
Yamanaka Junichi,
Hirano Tadamichi,
Saito Shinichi,
Sugimoto Takaaki,
Watanabe Shinichiro,
Kuroda Nobukazu,
Okada Toshihiro,
Asano Yasukane,
Uyama Naoki,
Fujimoto Jiro
Publication year - 2010
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-010-0264-6
Subject(s) - asialoglycoprotein receptor , liver function , hepatocellular carcinoma , medicine , hepatectomy , nuclear medicine , albumin , liver function tests , positron emission tomography , prothrombin time , scintigraphy , radiology , hepatocyte , gastroenterology , biology , surgery , resection , in vitro , biochemistry
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 99m technetium‐galactosyl human serum albumin ( 99m Tc‐GSA)/single photon emission computed tomography (SPECT) and computed tomography (CT) scanning. The liver uptake ratio (LUR) of 99m Tc‐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 99m Tc‐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.