Prediction of Posthepatectomy Liver Failure Proposed by the International Study Group of Liver Surgery: Residual Liver Function Estimation With 99mTc-Galactosyl Human Serum Albumin Scintigraphy. (February 2018)

• Record Type: Journal Article
• Authors: Mizutani, Yoichi; Hirai, Toshinori; Nagamachi, Shigeki; Nanashima, Atsushi; Yano, Koichi; Kondo, Kazuhiro; Hiyoshi, Masahide; Imamura, Naoya; Terada, Tamasa
• Is Part Of: Clinical nuclear medicine. Volume 43:Number 2(2018)
• Publication Date: 2018-02
• Subjects: 99mTc-GSA scintigraphy -- liver failure -- posthepatectomy; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000001913
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: The International Study Group of Liver Surgery (ISGLS) proposed a definition and grading system for posthepatectomy liver failure (PHLF). We evaluated the usefulness of residual liver function estimation using 99m Tc-galactosyl human serum albumin ( 99m Tc-GSA) for the prediction of PHLF. Methods: Patients with liver tumors (n = 136) and scheduled for hepatectomy underwent 99m Tc-GSA scintigraphy. Based on their imaging data, the maximal GSA removal rate (GSA-Rmax)was calculated using multicompartment analysis. We also calculated GSA-Rmax in the predicted residual liver (GSA-RL) whose volume was determined on computed tomography (CT) scans. We compared the age, sex, 15-minute indocyanine green retention rate; albumin, bilirubin, hyaluronic acid, and type 4 collagen levels; the Child-Pugh classification; residual liver volume; residual liver percentage; GSA-Rmax; and GSA-RL in patients with and without PHLF. Univariate and multivariate logistic analyses were used for statistical assessments. Results: Of 136 patients, 17 (12.5%) met the ISGLS criteria for PHLF (ISGLS-PHLF). There was a statistically significant difference in the age, albumin level, Child-Pugh classification, residual liver volume, residual liver percentage, GSA-Rmax, and GSA-RL between patients with and without PHLF. Based on multivariate analysis, GSA-RL and the residual liver volume were significant independent predictors of ISGLS-PHLF ( P = 0.004 and P = 0.038, respectively). The odds ratio was 149423 for GSA-RL and 1.003 for the residual liver volume. Conclusions: GSA-RL calculated using 99m Tc-GSA scintigraphy was the most useful independent predictor for ISGLS-PHLF.