Liver functional volumetry for portal vein embolization using a newly developed 99mTc-galactosyl human serum albumin scintigraphy SPECT-computed tomography fusion system.

Journal of gastroenterology

PubMedID: 21523415

Beppu T, Hayashi H, Okabe H, Masuda T, Mima K, Otao R, Chikamoto A, Doi K, Ishiko T, Takamori H, Yoshida M, Shiraishi S, Yamashita Y, Baba H. Liver functional volumetry for portal vein embolization using a newly developed 99mTc-galactosyl human serum albumin scintigraphy SPECT-computed tomography fusion system. J Gastroenterol. 2011;46(7):938-43.
BACKGROUND
We developed a new combined (99m)Tc-galactosyl human serum albumin (GSA) scintigraphy single-photon emission computed tomography (SPECT)/CT system to evaluate the changes in functional liver volume with portal vein embolization (PVE).

METHODS
We performed a prospective analysis of 25 patients treated with right PVE, and evaluated their functional liver volume perioperatively with a (99m)Tc-GSA scintigraphy SPECT-CT fusion system. The percentage of the non-tumorous remnant liver volume (%LV) and the percentage of functional remnant liver volume (%FLV) were estimated by using the following calculations: (future remnant volume - tumor volume)/(total liver volume - tumor volume) and functional future remnant liver volume/functional total liver volume, respectively.

RESULTS
Before PVE, the correlation was strongly significant between %LV and %FLV of the non-embolized liver, and the data were nearly equal (the regression coefficient was 1.005, P < 0.0001). In contrast, after PVE, there was a significant correlation between %LV and %FLV (P < 0.0001), but the regression coefficient was 1.192. The % LV increased significantly, from 38.1 to 52.0%, and the increment was 13.9% (P < 0.0005). The %FLV was also increased significantly, from 36.6 to 58.0%, and the increment was 21.4% (P < 0.0001). The increment was 7.5% greater for the %FLV compared to that of the %LV (P < 0.001).

CONCLUSIONS
The (99m)Tc-GSA scintigraphy SPECT-CT fusion system can estimate the correct functional liver volume and is useful in comparison with conventional CT volumetry.