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Erschienen in: Japanese Journal of Radiology 4/2019

17.01.2019 | Original Article

Liver fibrosis assessment using 99mTc-GSA SPECT/CT fusion imaging

verfasst von: Ryotaro Tokorodani, Tatsuaki Sumiyoshi, Takehiro Okabayashi, Yasuhiro Hata, Yoshihiro Noda, Sojiro Morita, Hiromitsu Daisaki, Yukinori Okada, Eisuke Yasuda

Erschienen in: Japanese Journal of Radiology | Ausgabe 4/2019

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Abstract

Purpose

To determine the utility of mean standardized uptake value (SUVmean) of whole liver measured by 99mTc-GSA SPECT/CT fusion imaging, for evaluation of liver fibrosis.

Materials and methods

Eighty-six patients who underwent hepatectomy were enrolled, and were classified into the non-fibrosis or fibrosis group based on the pathological findings in the resected liver specimen. Univariate and multivariate analyses were performed between the two groups on four blood biochemical indices (albumin, total bilirubin, platelet count, and prothrombin time activity) and two 99mTc-GSA scintigraphy-derived liver function indices (LHL15 and SUVmean) to evaluate the independent predictive value for severe fibrosis. The diagnostic value of the index for severe fibrosis was assessed by calculating the area under the receiver operating characteristic curve.

Results

Multivariate analysis showed that prothrombin time activity [odds ratio (OR) 0.519], LHL15 (OR 0.513), and SUVmean (OR 0.168) significantly correlated with liver fibrosis. SUVmean showed the largest area under the curve, with value of 0.804, 0.730 for platelet count, 0.717 for LHL15, and 0.668 for prothrombin time activity. The optimal cut-off value for SUVmean was 6.7, which yielded 62.9% sensitivity and 96.9% specificity.

Conclusions

SUVmean measured by 99mTc-GSA SPECT/CT fusion imaging enables highly accurate prediction of severe liver fibrosis.
Literatur
1.
Zurück zum Zitat Farges O, Malassagne B, Flejou JF, Balzan S, Sauvanet A, Belghiti J. Risk of major liver resection in patients with underlying chronic liver disease: a reappraisal. Ann Surg. 1999;229:210–5.CrossRefPubMedPubMedCentral Farges O, Malassagne B, Flejou JF, Balzan S, Sauvanet A, Belghiti J. Risk of major liver resection in patients with underlying chronic liver disease: a reappraisal. Ann Surg. 1999;229:210–5.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y. Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann Surg. 2006;243:364–72.CrossRefPubMedPubMedCentral Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y. Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann Surg. 2006;243:364–72.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Zarzavadjian A, Bian L, Costi R, Sbai-Idrissi MS, Smadja C. Liver resection and metabolic disorders: an undescribed mechanism leading to postoperative mortality. World J Gastroenterol. 2014;20:55–62. Zarzavadjian A, Bian L, Costi R, Sbai-Idrissi MS, Smadja C. Liver resection and metabolic disorders: an undescribed mechanism leading to postoperative mortality. World J Gastroenterol. 2014;20:55–62.
4.
Zurück zum Zitat Wang Q, Fiel M, Blank S, Luan W, Kadri H, Kim KW, et al. Impact of liver fibrosis on prognosis following liver resection for hepatitis B-associated hepatocellular carcinoma. Br J Cancer. 2013;109:573–81.CrossRefPubMedPubMedCentral Wang Q, Fiel M, Blank S, Luan W, Kadri H, Kim KW, et al. Impact of liver fibrosis on prognosis following liver resection for hepatitis B-associated hepatocellular carcinoma. Br J Cancer. 2013;109:573–81.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Sumiyoshi T, Shima Y, Okabayashi T, Noda Y, Hata Y, Murata Y, et al. Functional discrepancy between two liver lobes after hemilobe biliary drainage in patients with jaundice and bile duct cancer: an appraisal using 99mTc-GSA SPECT/CT fusion. Radiology. 2014;273:444–51.CrossRefPubMed Sumiyoshi T, Shima Y, Okabayashi T, Noda Y, Hata Y, Murata Y, et al. Functional discrepancy between two liver lobes after hemilobe biliary drainage in patients with jaundice and bile duct cancer: an appraisal using 99mTc-GSA SPECT/CT fusion. Radiology. 2014;273:444–51.CrossRefPubMed
6.
Zurück zum Zitat Sobue G, Kosaka A. Asialoglycoproteinemia in a case of primary hepatic cancer. Hepatogastroenterology. 1980;27:200–3.PubMed Sobue G, Kosaka A. Asialoglycoproteinemia in a case of primary hepatic cancer. Hepatogastroenterology. 1980;27:200–3.PubMed
7.
Zurück zum Zitat Marshall JS, Green AM, Pensky J, Williams S, Zinn A, Carlson DM. Measurement of circulating desialylated glycoproteins and correlation with hepatocellular damage. J Clin Investig. 1974;54:555–62.CrossRefPubMedPubMedCentral Marshall JS, Green AM, Pensky J, Williams S, Zinn A, Carlson DM. Measurement of circulating desialylated glycoproteins and correlation with hepatocellular damage. J Clin Investig. 1974;54:555–62.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Okabayashi T, Shima Y, Morita S, Shimada Y, Sumiyoshi T, Sui K, et al. Liver function assessment using technetium 99m-Galactosyl single-photon emission computed tomography/CT fusion imaging: a prospective trial. J Am Coll Surg. 2017;225:789–97.CrossRefPubMed Okabayashi T, Shima Y, Morita S, Shimada Y, Sumiyoshi T, Sui K, et al. Liver function assessment using technetium 99m-Galactosyl single-photon emission computed tomography/CT fusion imaging: a prospective trial. J Am Coll Surg. 2017;225:789–97.CrossRefPubMed
9.
Zurück zum Zitat Okabe H, Beppu T, Hayashi H, Mima K, Nakagawa S, Kuroki H, et al. Rank classification based on the combination of indocyanine green retention rate at 15 min and (99m) Tc-DTPA-galactosyl human serum albumin scintigraphy predicts the safety of hepatic resection. Nucl Med Commun. 2014;35:478–83.CrossRefPubMed Okabe H, Beppu T, Hayashi H, Mima K, Nakagawa S, Kuroki H, et al. Rank classification based on the combination of indocyanine green retention rate at 15 min and (99m) Tc-DTPA-galactosyl human serum albumin scintigraphy predicts the safety of hepatic resection. Nucl Med Commun. 2014;35:478–83.CrossRefPubMed
10.
Zurück zum Zitat Hasegawa D, Onishi H. Evaluation of accuracy for quantitative predictor of hepatic functional reserve using planar and SPECT images in the 99mTc-GSA scintigraphy. Nihon Hoshasen Gijutsu Gakkai Zasshi. 2017;73:1055–60.CrossRefPubMed Hasegawa D, Onishi H. Evaluation of accuracy for quantitative predictor of hepatic functional reserve using planar and SPECT images in the 99mTc-GSA scintigraphy. Nihon Hoshasen Gijutsu Gakkai Zasshi. 2017;73:1055–60.CrossRefPubMed
11.
Zurück zum Zitat Suh MS, Lee WW, Kim YK, Yun PY, Kim SE. Maximum standardized uptake value of 99mTc hydroxymethylene diphosphonate SPECT/CT for the evaluation of temporomandibular joint disorder. Radiology. 2016;280:890–6.CrossRefPubMed Suh MS, Lee WW, Kim YK, Yun PY, Kim SE. Maximum standardized uptake value of 99mTc hydroxymethylene diphosphonate SPECT/CT for the evaluation of temporomandibular joint disorder. Radiology. 2016;280:890–6.CrossRefPubMed
12.
Zurück zum Zitat Kinahan PE, Fletcher JW. Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy. Semin Ultrasound CT MR. 2010;31:496–505.CrossRefPubMedPubMedCentral Kinahan PE, Fletcher JW. Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy. Semin Ultrasound CT MR. 2010;31:496–505.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Kokudo N, Vera DR, Makuuchi M. Clinical application of TcGSA. Nucl Med Biol. 2003;30:845–9.CrossRefPubMed Kokudo N, Vera DR, Makuuchi M. Clinical application of TcGSA. Nucl Med Biol. 2003;30:845–9.CrossRefPubMed
14.
Zurück zum Zitat Kwon AH, Ha-Kawa SK, Uetsuji S, Kamiyama Y, Tanaka Y. Preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin (GSA-Rmax) is useful for judging the safety of hepatic resection. Surgery. 1995;117:429–34.CrossRefPubMed Kwon AH, Ha-Kawa SK, Uetsuji S, Kamiyama Y, Tanaka Y. Preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin (GSA-Rmax) is useful for judging the safety of hepatic resection. Surgery. 1995;117:429–34.CrossRefPubMed
15.
Zurück zum Zitat Oshiro Y, Ohkohchi N. Three-dimensional liver surgery simulation: computer-assisted surgical planning with three-dimensional simulation software and three-dimensional printing. Tissue Eng Part A. 2017;23:474–80.CrossRefPubMed Oshiro Y, Ohkohchi N. Three-dimensional liver surgery simulation: computer-assisted surgical planning with three-dimensional simulation software and three-dimensional printing. Tissue Eng Part A. 2017;23:474–80.CrossRefPubMed
16.
Zurück zum Zitat Ludwig J (1993) The nomenclature of chronic active hepatitis: an obituary. Gastroenterology 105:274–278 Ludwig J (1993) The nomenclature of chronic active hepatitis: an obituary. Gastroenterology 105:274–278
17.
Zurück zum Zitat Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V et al (2007) FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. Comparison with liver biopsy and fibrotest. Hepatology 46:32–36 Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V et al (2007) FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. Comparison with liver biopsy and fibrotest. Hepatology 46:32–36
18.
Zurück zum Zitat Jabor A, Kubíček Z, Fraňková S, Šenkeříková R, Franeková J. Enhanced liver fibrosis (ELF) score: Reference ranges, biological variation in healthy subjects, and analytical considerations. Clin Chim Acta. 2018;483:291–5.CrossRefPubMed Jabor A, Kubíček Z, Fraňková S, Šenkeříková R, Franeková J. Enhanced liver fibrosis (ELF) score: Reference ranges, biological variation in healthy subjects, and analytical considerations. Clin Chim Acta. 2018;483:291–5.CrossRefPubMed
19.
Zurück zum Zitat Gudowska M, Cylwik B, Chrostek L. The role of serum hyaluronic acid determination in the diagnosis of liver fibrosis. Acta Biochim Pol. 2017;64:451–7.CrossRefPubMed Gudowska M, Cylwik B, Chrostek L. The role of serum hyaluronic acid determination in the diagnosis of liver fibrosis. Acta Biochim Pol. 2017;64:451–7.CrossRefPubMed
20.
Zurück zum Zitat Khan S, Subedi D, Chowdhury UMM (2006) Use of amino terminal type III procollagen peptide (P3NP) assay in methotrexate therapy for psoriasis. Postgrad Med J 82:353–354 Khan S, Subedi D, Chowdhury UMM (2006) Use of amino terminal type III procollagen peptide (P3NP) assay in methotrexate therapy for psoriasis. Postgrad Med J 82:353–354
21.
Zurück zum Zitat Murawaki Y, Ikuta Y, Nishimura Y, Koda M, Kawasaki H. Serum markers for connective tissue turnover in patients with chronic hepatitis B and chronic hepatitis C: a comparative analysis. J Hepatol. 1995;23:145–52.CrossRefPubMed Murawaki Y, Ikuta Y, Nishimura Y, Koda M, Kawasaki H. Serum markers for connective tissue turnover in patients with chronic hepatitis B and chronic hepatitis C: a comparative analysis. J Hepatol. 1995;23:145–52.CrossRefPubMed
22.
Zurück zum Zitat Bulatova IA, Schekotova AP, KrivtsovAV, Schekotov VV, Pavlov AI (2015) The noninvasive evaluation of degree of expression of fibrosis of liver and significance of polymorphism of gene of hyaluronic acid under chronic hepatitis C. Klin Lab Diagn 60:18–21 Bulatova IA, Schekotova AP, KrivtsovAV, Schekotov VV, Pavlov AI (2015) The noninvasive evaluation of degree of expression of fibrosis of liver and significance of polymorphism of gene of hyaluronic acid under chronic hepatitis C. Klin Lab Diagn 60:18–21
Metadaten
Titel
Liver fibrosis assessment using 99mTc-GSA SPECT/CT fusion imaging
verfasst von
Ryotaro Tokorodani
Tatsuaki Sumiyoshi
Takehiro Okabayashi
Yasuhiro Hata
Yoshihiro Noda
Sojiro Morita
Hiromitsu Daisaki
Yukinori Okada
Eisuke Yasuda
Publikationsdatum
17.01.2019
Verlag
Springer Japan
Erschienen in
Japanese Journal of Radiology / Ausgabe 4/2019
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-019-00810-w

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