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Erschienen in: Journal of Hepato-Biliary-Pancreatic Sciences 5/2010

01.09.2010 | Original article

Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters

verfasst von: Yuji Iimuro, Toru Kashiwagi, Junichi Yamanaka, Tadamichi Hirano, Shinichi Saito, Takaaki Sugimoto, Shinichiro Watanabe, Nobukazu Kuroda, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Jiro Fujimoto

Erschienen in: Journal of Hepato-Biliary-Pancreatic Sciences | Ausgabe 5/2010

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Abstract

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 99mtechnetium-galactosyl human serum albumin (99mTc-GSA)/single photon emission computed tomography (SPECT) and computed tomography (CT) scanning. The liver uptake ratio (LUR) of 99mTc-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 99mTc-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.
Literatur
1.
Zurück zum Zitat Nagasue N, Kohno H, Chang YC, Taniura H, Yamanoi A, Uchida M, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg. 1993;217:375–84.CrossRefPubMed Nagasue N, Kohno H, Chang YC, Taniura H, Yamanoi A, Uchida M, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg. 1993;217:375–84.CrossRefPubMed
2.
Zurück zum Zitat Imamura H, Sano K, Sugawara Y, Kokudo N, Makuuchi M. Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg. 2005;12:16–22.CrossRefPubMed Imamura H, Sano K, Sugawara Y, Kokudo N, Makuuchi M. Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg. 2005;12:16–22.CrossRefPubMed
3.
Zurück zum Zitat Okamoto E, Kyo A, Yamanaka N, Tanaka N, Kuwata K. Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. Surgery. 1984;95:586–92.PubMed Okamoto E, Kyo A, Yamanaka N, Tanaka N, Kuwata K. Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. Surgery. 1984;95:586–92.PubMed
4.
Zurück zum Zitat Truant S, Oberlin O, Sergent G, Lebuffe G, Gambiez L, Ernst O, et al. Remnant liver volume to body weight ratio > or = 0.5%: a new cut-off to estimate postoperative risks after extended resection in noncirrhotic liver. J Am Coll Surg. 2007;204:22–33.CrossRefPubMed Truant S, Oberlin O, Sergent G, Lebuffe G, Gambiez L, Ernst O, et al. Remnant liver volume to body weight ratio > or = 0.5%: a new cut-off to estimate postoperative risks after extended resection in noncirrhotic liver. J Am Coll Surg. 2007;204:22–33.CrossRefPubMed
5.
Zurück zum Zitat Ashwell G, Morell AG. The role of surface carbohydrates in the hepatic recognition and transport of circulating glycoproteins. Adv Enzymol Relat Areas Mol Biol. 1974;41:99–128.PubMed Ashwell G, Morell AG. The role of surface carbohydrates in the hepatic recognition and transport of circulating glycoproteins. Adv Enzymol Relat Areas Mol Biol. 1974;41:99–128.PubMed
6.
Zurück zum Zitat Kubota Y, Kitagawa S, Inoue K, Ha-Kawa SK, Kojima M, Tanaka Y. Hepatic functional scintigraphic imaging with 99 mtechnetium galactosyl serum albumin. Hepatogastroenterology. 1993;40:32–6.PubMed Kubota Y, Kitagawa S, Inoue K, Ha-Kawa SK, Kojima M, Tanaka Y. Hepatic functional scintigraphic imaging with 99 mtechnetium galactosyl serum albumin. Hepatogastroenterology. 1993;40:32–6.PubMed
7.
Zurück zum Zitat Imaeda T, Kanematsu M, Asada S, Seki M, Doi H, Saji S. Utility of Tc-99 m GSA SPECT imaging in estimation of functional volume of liver segments in health and liver diseases. Clin Nucl Med. 1995;20:322–8.CrossRefPubMed Imaeda T, Kanematsu M, Asada S, Seki M, Doi H, Saji S. Utility of Tc-99 m GSA SPECT imaging in estimation of functional volume of liver segments in health and liver diseases. Clin Nucl Med. 1995;20:322–8.CrossRefPubMed
8.
Zurück zum Zitat Akaki S, Okumura Y, Sasai N, Sato S, Tsunoda M, Kuroda M, et al. Hepatectomy simulation discrepancy between radionuclide receptor imaging and CT volumetry: influence of decreased unilateral portal venous flow. Ann Nucl Med. 2003;17:23–9.CrossRefPubMed Akaki S, Okumura Y, Sasai N, Sato S, Tsunoda M, Kuroda M, et al. Hepatectomy simulation discrepancy between radionuclide receptor imaging and CT volumetry: influence of decreased unilateral portal venous flow. Ann Nucl Med. 2003;17:23–9.CrossRefPubMed
9.
Zurück zum Zitat Yokoyama Y, Nagino M, Nishio H, Ebata T, Igami T, Nimura Y. Recent advances in the treatment of hilar cholangiocarcinoma: portal vein embolization. J Hepatobiliary Pancreat Surg. 2007;14:447–54.CrossRefPubMed Yokoyama Y, Nagino M, Nishio H, Ebata T, Igami T, Nimura Y. Recent advances in the treatment of hilar cholangiocarcinoma: portal vein embolization. J Hepatobiliary Pancreat Surg. 2007;14:447–54.CrossRefPubMed
10.
Zurück zum Zitat Onodera Y, Takahashi K, Togashi T, Sugai Y, Tamaki N, Miyasaka K. Clinical assessment of hepatic functional reserve using 99mTc DTPA galactosyl human serum albumin SPECT to prognosticate chronic hepatic diseases—validation of the use of SPECT and a new indicator. Ann Nucl Med. 2003;17:181–8.CrossRefPubMed Onodera Y, Takahashi K, Togashi T, Sugai Y, Tamaki N, Miyasaka K. Clinical assessment of hepatic functional reserve using 99mTc DTPA galactosyl human serum albumin SPECT to prognosticate chronic hepatic diseases—validation of the use of SPECT and a new indicator. Ann Nucl Med. 2003;17:181–8.CrossRefPubMed
11.
Zurück zum Zitat Kashiwagi T, Yutani K, Fukuchi M, Naruse H, Iwasaki T, Yokozuka K, et al. Correction of nonuniform attenuation and image fusion in SPECT imaging by means of separate X-ray CT. Ann Nucl Med. 2002;16:255–61.CrossRefPubMed Kashiwagi T, Yutani K, Fukuchi M, Naruse H, Iwasaki T, Yokozuka K, et al. Correction of nonuniform attenuation and image fusion in SPECT imaging by means of separate X-ray CT. Ann Nucl Med. 2002;16:255–61.CrossRefPubMed
12.
Zurück zum Zitat Couinaud C. Surgical anatomy of the liver. Several new aspects. Chirurgie. 1986;112:337–42.PubMed Couinaud C. Surgical anatomy of the liver. Several new aspects. Chirurgie. 1986;112:337–42.PubMed
13.
Zurück zum Zitat IHPBA Ttcot. The Brisbane 2000 terminology of hepatic anatomy and resections. HPB. 2000; 2:333–9. IHPBA Ttcot. The Brisbane 2000 terminology of hepatic anatomy and resections. HPB. 2000; 2:333–9.
14.
Zurück zum Zitat Ha-Kawa SK, Tanaka Y, Hasebe S, Kuniyasu Y, Koizumi K, Ishii Y, et al. Compartmental analysis of asialoglycoprotein receptor scintigraphy for quantitative measurement of liver function: a multicentre study. Eur J Nucl Med. 1997;24:130–7.CrossRefPubMed Ha-Kawa SK, Tanaka Y, Hasebe S, Kuniyasu Y, Koizumi K, Ishii Y, et al. Compartmental analysis of asialoglycoprotein receptor scintigraphy for quantitative measurement of liver function: a multicentre study. Eur J Nucl Med. 1997;24:130–7.CrossRefPubMed
15.
Zurück zum Zitat Wu J, Ishikawa N, Takeda T, Tanaka Y, Pan XQ, Sato M, et al. The functional hepatic volume assessed by 99 mTc-GSA hepatic scintigraphy. Ann Nucl Med. 1995;9:229–35.CrossRefPubMed Wu J, Ishikawa N, Takeda T, Tanaka Y, Pan XQ, Sato M, et al. The functional hepatic volume assessed by 99 mTc-GSA hepatic scintigraphy. Ann Nucl Med. 1995;9:229–35.CrossRefPubMed
16.
Zurück zum Zitat Sugahara K, Togashi H, Takahashi K, Onodera Y, Sanjo M, Misawa K, et al. Separate analysis of asialoglycoprotein receptors in the right and left hepatic lobes using Tc-GSA SPECT. Hepatology. 2003;38:1401–9.PubMed Sugahara K, Togashi H, Takahashi K, Onodera Y, Sanjo M, Misawa K, et al. Separate analysis of asialoglycoprotein receptors in the right and left hepatic lobes using Tc-GSA SPECT. Hepatology. 2003;38:1401–9.PubMed
17.
Zurück zum Zitat Iimuro Y, Nishio T, Morimoto T, Nitta T, Stefanovic B, Choi SK, et al. Delivery of matrix metalloproteinase-1 attenuates established liver fibrosis in the rat. Gastroenterology. 2003;124:445–58.CrossRefPubMed Iimuro Y, Nishio T, Morimoto T, Nitta T, Stefanovic B, Choi SK, et al. Delivery of matrix metalloproteinase-1 attenuates established liver fibrosis in the rat. Gastroenterology. 2003;124:445–58.CrossRefPubMed
18.
Zurück zum Zitat Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology. 1981;1:431–5.CrossRefPubMed Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology. 1981;1:431–5.CrossRefPubMed
19.
Zurück zum Zitat Hwang EH, Taki J, Shuke N, Nakajima K, Kinuya S, Konishi S, et al. Preoperative assessment of residual hepatic functional reserve using 99mTc-DTPA-galactosyl-human serum albumin dynamic SPECT. J Nucl Med. 1999;40:1644–51.PubMed Hwang EH, Taki J, Shuke N, Nakajima K, Kinuya S, Konishi S, et al. Preoperative assessment of residual hepatic functional reserve using 99mTc-DTPA-galactosyl-human serum albumin dynamic SPECT. J Nucl Med. 1999;40:1644–51.PubMed
20.
Zurück zum Zitat Satoh K, Yamamoto Y, Nishiyama Y, Wakabayashi H, Ohkawa M. 99mTc-GSA liver dynamic SPECT for the preoperative assessment of hepatectomy. Ann Nucl Med. 2003;17:61–7.CrossRefPubMed Satoh K, Yamamoto Y, Nishiyama Y, Wakabayashi H, Ohkawa M. 99mTc-GSA liver dynamic SPECT for the preoperative assessment of hepatectomy. Ann Nucl Med. 2003;17:61–7.CrossRefPubMed
21.
Zurück zum Zitat Shuke N, Okizaki A, Kino S, Sato J, Ishikawa Y, Zhao C, et al. Functional mapping of regional liver asialoglycoprotein receptor amount from single blood sample and SPECT. J Nucl Med. 2003;44:475–82.PubMed Shuke N, Okizaki A, Kino S, Sato J, Ishikawa Y, Zhao C, et al. Functional mapping of regional liver asialoglycoprotein receptor amount from single blood sample and SPECT. J Nucl Med. 2003;44:475–82.PubMed
22.
Zurück zum Zitat Takahashi Y, Murase K, Mochizuki T, Higashino H, Sugawara Y, Kinda A. A study on attenuation correction using Tc-99m external TCT source in Tc-99m GSA liver SPECT. Ann Nucl Med. 2004;18:585–90.CrossRefPubMed Takahashi Y, Murase K, Mochizuki T, Higashino H, Sugawara Y, Kinda A. A study on attenuation correction using Tc-99m external TCT source in Tc-99m GSA liver SPECT. Ann Nucl Med. 2004;18:585–90.CrossRefPubMed
23.
Zurück zum Zitat Kwon AH, Matsui Y, Kaibori M, Ha-Kawa SK. Preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin (GSA-Rmax) is useful for judging the safety of hepatic resection. Surgery. 2006;140:379–86.CrossRefPubMed Kwon AH, Matsui Y, Kaibori M, Ha-Kawa SK. Preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin (GSA-Rmax) is useful for judging the safety of hepatic resection. Surgery. 2006;140:379–86.CrossRefPubMed
24.
Zurück zum Zitat Li XF, Taki J, Kinuya S, Higuchi T, Konishi S, Hwang EH, et al. Asialoglycoprotein receptor concentration in tumor-bearing livers and its fate early after their sectorial resection. Ann Nucl Med. 2003;17:489–93.CrossRefPubMed Li XF, Taki J, Kinuya S, Higuchi T, Konishi S, Hwang EH, et al. Asialoglycoprotein receptor concentration in tumor-bearing livers and its fate early after their sectorial resection. Ann Nucl Med. 2003;17:489–93.CrossRefPubMed
25.
Zurück zum Zitat Kwon AH, Matsui Y, Kaibori M, Kamiyama Y. Functional hepatic regeneration following hepatectomy using galactosyl-human serum albumin liver scintigraphy. Transplant Proc. 2004;36:2257–60.CrossRefPubMed Kwon AH, Matsui Y, Kaibori M, Kamiyama Y. Functional hepatic regeneration following hepatectomy using galactosyl-human serum albumin liver scintigraphy. Transplant Proc. 2004;36:2257–60.CrossRefPubMed
Metadaten
Titel
Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99mTc-GSA SPECT fusion images correlates well with postoperative liver function parameters
verfasst von
Yuji Iimuro
Toru Kashiwagi
Junichi Yamanaka
Tadamichi Hirano
Shinichi Saito
Takaaki Sugimoto
Shinichiro Watanabe
Nobukazu Kuroda
Toshihiro Okada
Yasukane Asano
Naoki Uyama
Jiro Fujimoto
Publikationsdatum
01.09.2010
Verlag
Springer Japan
Erschienen in
Journal of Hepato-Biliary-Pancreatic Sciences / Ausgabe 5/2010
Print ISSN: 1868-6974
Elektronische ISSN: 1868-6982
DOI
https://doi.org/10.1007/s00534-010-0264-6

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