Relationship of Hepatic Functional Parameters with Changes of Functional Liver Volume Using Technetium-99m Galactosyl Serum Albumin Scintigraphy in Patients Undergoing Preoperative Portal Vein Embolization: A Follow-Up Report

• Published in: The Journal of surgical research Vol. 164; no. 2; pp. e235 - e242
• Main Authors: Nanashima, Atsushi, Tobinaga, Syuuichi, Abo, Takafumi, Sumida, Yorihisa, Araki, Masato, Hayashi, Hideyuki, Sakamoto, Ichiro, Kudo, Takashi, Takeshita, Hiroaki, Hidaka, Shigekazu, Sawai, Terumitsu, Hatano, Kazuhiko, Nagayasu, Takeshi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2010
• Subjects: Adult; Aged; Embolization, Therapeutic - methods; Female; functional liver volume; Hepatectomy - adverse effects; Hepatectomy - methods; Humans; Indocyanine Green - pharmacokinetics; Liver - anatomy & histology; Liver - diagnostic imaging; Liver - surgery; Liver Diseases - classification; Liver Diseases - surgery; liver functional reserve; liver resection; Male; Middle Aged; platelet count; Portal Vein - anatomy & histology; Portal Vein - diagnostic imaging; Portal Vein - surgery; portal vein embolization; Postoperative Complications - prevention & control; Prognosis; Radionuclide Imaging; Retrospective Studies; Surgery; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Pentetate; Tomography, X-Ray Computed - methods; liver functional reserve; platelet count; liver resection; functional liver volume; portal vein embolization
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2010.06.003

To identify predictors of changes in functional hepatic volumes after portal vein embolization (PVE) before hepatectomy, we examined the relationship between hepatic functional parameters and changes in functional volume of the embolized and non-embolized liver based on a previous volumetric analysis. Subjects were 24 patients who underwent PVE, which was performed through the trans-ileocolic vein ( n = 4) or by percutaneous transhepatic puncture ( n = 20). The RI liver volume parameter was measured by liver scintigraphy with technetium- 99m galactosyl human serum albumin ( 99mTc-GSA). Computed tomography (CT) volume parameter was also measured. Significant atrophy of the embolized liver and hypertrophy of the non-embolized liver (change of 72 ± 108 cm 3 and 111 ± 91cm 3, respectively) (change of 7.8%) was observed after PVE. The change in these RI volume parameters (change of 173 ± 175cm 3 and 145 ± 137 cm 3 , respectively) (16.5%) was significantly greater than CT volume parameters ( P < 0.01). CT vol and RI vol in the embolized and non-embolized liver were well correlated (r = 0.75 and 0.69, respectively). However, the correlation between CT and RI volume parameters in the embolized and non-embolized liver after PVE was very weak (r = 0.17 and 0.03, respectively). Only alkaline phosphatase level correlated negatively with atrophic CT volume parameter of the embolized liver (r = –0.455, P < 0.05). When compared with CT volume parameter, more parameters were significantly correlated with changes of RI volume parameter in the embolized liver: pre-PVE pressure; ICGR15; and serum levels of hyaluronate, total bilirubin, albumin, and alkaline phosphatase. Only platelet count was significantly correlated with hypertrophy of the non-embolized liver. RI volume parameter might more accurately reflect functional changes in the embolized liver and non-embolized liver than CT volume parameter. Correlated parameters might allow us to predict the functional effect of PVE.