Estimation of post-therapeutic liver reserve capacity using 99mTc-GSA scintigraphy prior to carbon-ion radiotherapy for liver tumors
- 4 October 2022
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Nuclear Medicine and Molecular Imaging
- Vol. 50 (2), 581-592
- https://doi.org/10.1007/s00259-022-05985-5
Abstract
Background There is currently no established imaging method for assessing liver reserve capacity prior to carbon-ion radiotherapy (CIRT) for liver tumors. In order to perform safe CIRT, it is essential to estimate the post-therapeutic residual reserve capacity of the liver. Purpose To evaluate the ability of pre-treatment 99mTc-galactosyl human serum albumin (99mTc-GSA) scintigraphy to accurately estimate the residual liver reserve capacity in patients treated with CIRT for liver tumors. Materials and methods This retrospective study evaluated patients who were performed CIRT for liver tumors between December 2018 and September 2020 and underwent 99mTc-GSA scintigraphy before and 3 months after CIRT, and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI within 1 month before CIRT were evaluated. The maximal removal rate of 99mTc-GSA (GSA-Rmax) was analyzed for the evaluation of pre-treatment liver reserve capacity. Then, the GSA-Rmax of the estimated residual liver (GSA-RL) was calculated using liver SPECT images fused with the Gd-EOB-DTPA-enhanced MRI. GSA-RL before CIRT and GSA-Rmax at 3 months after CIRT were compared using non-parametric Wilcoxon signed-rank test and linear regression analysis. Results Overall, 50 patients were included (mean age ± standard deviation, 73 years ± 11; range, 29–89 years, 35 men). The median GSA-RL was 0.393 [range, 0.057–0.729] mg/min, and the median GSA-Rmax after CIRT was 0.369 [range, 0.037–0.780] mg/min (P = .40). The linear regression equation representing the relationship between the GSA-RL and GSA-Rmax after CIRT was y = 0.05 + 0.84x (R2 = 0.67, P < .0001). There was a linear relationship between the estimated and actual post-treatment values for all patients, as well as in the group with impaired liver reserve capacity (y = − 0.02 + 1.09x (R2 = 0.62, P = .0005)). Conclusions 99mTc-GSA scintigraphy has potential clinical utility for estimating the residual liver reserve capacity in patients undergoing carbon-ion radiotherapy for liver tumors. Trial registration UMIN000038328, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043545.Keywords
This publication has 38 references indexed in Scilit:
- EASL–EORTC Clinical Practice Guidelines: Management of hepatocellular carcinomaEuropean Journal of Cancer, 2012
- Fused 99m-Tc-GSA SPECT/CT imaging for the preoperative evaluation of postoperative liver function: can the liver uptake index predict postoperative hepatic functional reserve?Japanese Journal of Radiology, 2012
- Radioembolization Results in Longer Time-to-Progression and Reduced Toxicity Compared With Chemoembolization in Patients With Hepatocellular CarcinomaGastroenterology, 2011
- Predictive value of Tc-99m galactosyl human serum albumin liver SPECT on the assessment of functional recovery after partial hepatectomy: a comparison with CT volumetryAnnals of Nuclear Medicine, 2010
- Sequential evaluation of hepatic functional reserve by99mTechnetium-galactosyl human serum albumin scinitigraphy after proton beam therapy: a report of three cases and a review of the literaturesActa Oncologica, 2006
- Separate analysis of asialoglycoprotein receptors in the right and left hepatic lobes using Tc-GSA SPECTJournal of Hepatology, 2003
- Estimation of fractional liver uptake and blood retention of 99mTc-DTPA-galactosyl human serum albumin: an application of a simple graphical method to dynamic SPECTNuclear Medicine Communications, 2003
- Major hepatectomy for hepatocellular carcinoma in patients with an unsatisfactory indocyanine green clearance testBritish Journal of Surgery, 1999
- The relative role of the child-pugh classification and the mayo natural history model in the assessment of survival in patients with primary sclerosing cholangitisJournal of Hepatology, 1999
- Preoperative determination of the surgical procedure for hepatectomy using technetium-99m-galactosyl human serum albumin (99mTc-GSA) liver scintigraphyJournal of Hepatology, 1997