Abstract
37
Objectives Standardization and assessment of functional liver volume with 99mTc-Mebrofenin SPECT.
Methods Standardization and assessment of functional liver volume with 99mTc Mebrofenin SPECT was done with anthropometric liver phantom (kyotokagaku, co ltd, Japan) and the method was applied on 8 patients being worked up for liver resection with aim to assess SPECT derived functional liver volume. All patients underwent standard battery of pre-surgical tests including, CeCT volumetry which was performed with 64-slice (Phillips) CT scanner, before the SPECT. Based on biochemical liver functions patients were grouped into normal (n=6) and abnormal (n=2) liver parenchyma group. Out of these 8 patients who underwent resection, 6 had normal and 2 had abnormal liver parenchyma.
Results There was a very strong correlation between known phantom volume and measured phantom volume with SPECT (Pearson’s r=0.99). The total liver functional volume (TL-FV) measured by SPECT-CT was compared with morphologic non tumorous liver volume (NTTL-V, measured by CeCT volumetry). TL-FV had a strong and significant correlation with the NTTL-V (Pearson r =0.89) in patients with a normal (n=6) liver function, indicating the accuracy of 99mTc-mebrofenin SPECT-CT for the measurement of liver volume. However, in patients with a compromised (n=2) liver parenchyma TL-FV was significantly less than NTTL-V.
Conclusions 99m-Tc Mebrofenin SPECT-CT functional liver volume has potential to pre-surgically segregate patients with uncertain quality of liver parenchyma thus may help in identifying patients with higher post hepatectomy failure rates.
Research Support 1.Wilmar de Graaf, Krijn P. van Lienden, et al. 99mTc-Mebrofenin Hepatobiliary Scintigraphy with SPECT for the Assessment of Liver Functional Volume before Partial Hepatectomy. J Nucl Med 2010; 51:229-236. 2.Dinant S, de Graaf W, Verwer BJ, et al. Risk assessment of post hepatectomy liver failure using hepatobiliary scintigraphy and CT volumetry. J Nucl Med. 2007; 48:685-692.