Predictive value of Tc-99m galactosyl human serum albumin (GSA) hepatic SPECT on the assessment of functional recovery after partial hepatectomy: A comparison with CT volumetry

Objectives Predicting hepatic functional reserve is important before partial hepatectomy. However it is difficult to predict hepatic function reserve using morphologic imaging modalities such as CT, MRI. In this study, we assess the usefulness of galactosyl human serum albumin (GSA) scintigraphy in predicting hepatic functional recovery.

Methods We performed ^99mTc-GSA scintigraphy before operation in 56 patients. Each patient was administered 185 MBq of ^99mTc-GSA by intravenous injection. Dynamic images were taken immediately after the administration for 40 minutes. SPECT image was obtained to make a functional map. We calculated functioning parameter, residual GSA-Rmax (RGSA), using a software developed by Dr. N. Shuke. And we compared RGSA with morphological parameter, residual liver volume (RLV-CT) calculated by conventional CT and serum albumin (Alb) or cholinesterase (ChE). We analyzed the correlation between imaging parameters and the post-operative recovery periods of serum albumin (r-Alb) and cholinesterase (r-ChE) and the value at 1 and 3 months for serum albumin (1M-Alb, 3M-Alb) and cholinesterase (1M-ChE, 3M-ChE).

Results We found significant correlations between RGSA and r-Alb, r-ChE, 1M-Alb, 3M-Alb, 1M-ChE and 3M-ChE but we could not find significant correlations between RLV-CT with those parameters

Conclusions The RGSA calculated by ^99mTc GSA-SPECT was useful parameter for predicting post-operative liver functional recovery and it should be implemented before partial hepatectomy.