Shin Yanagisawa MD, Presenter: Nothing to Disclose

Akira Yamada MD, Abstract Co-Author: Nothing to Disclose

Hirokazu Tanaka, Abstract Co-Author: Nothing to Disclose

Shunsuke Fujii, Abstract Co-Author: Nothing to Disclose

Masahiro Kurozumi MD, Abstract Co-Author: Nothing to Disclose

Yasunari Fujinaga MD, Abstract Co-Author: Nothing to Disclose

Kazuhiko Ueda MD, Abstract Co-Author: Nothing to Disclose

Masumi Kadoya, Abstract Co-Author: Nothing to Disclose

To determine which can more precisely predict postoperative liver reserve preoperatively, gadoxetate disodium-enhanced MR imaging or 99mTc-galactosyl serum albumin (99mTc-GSA) scintigraphy.

Twelve consecutive patients (4 men, 8 women; mean age 70.3 years) who underwent gadoxetate disodium-enhanced MR imaging and 99mTc-GSA scintigraphy within 2 weeks before hepatectomy as a preoperative evaluation were included in this study. Remnant Hepatocellular Uptake Index: rHUI = rV[(rL20/S20) - 1] was determined from the future remnant liver volume (rV) and mean signal intensities of the future remnant liver (rL20) and the spleen (S20) on contrast enhanced MR images at 20 minutes after gadoxetate disodium administration. Receptor index of the future remnant liver: rLHL15 = rL%[L15/(H15 + L15)] was determined from the uptake ratio of the future remnant liver to the whole liver (rL%) on SPECT and the uptake of the liver (L15) and the heart (H15) on planar image of scintigraphy at 15 minutes after 99mTc-GSA administration. The correlation coefficients and its 95% confidence intervals (95%CIs) between indices for the segmental liver reserve (rHUI and rLHL15) and laboratory data at 1 week after hepatectomy (serum albumin, ALB; logarithm of serum total bilirubin, BIL; prothrombin time, PT) were evaluated. The significance of the correlation was evaluated by test for non-correlation.

Correlation coefficients and its probability values and 95%CIs were 0.69 (P = 0.012) [0.68, 0.71] for ALB, -0.30 (P = 0.339) [-0.32, -0.28] for BIL, and -0.69 (P = 0.024) [-0.71, -0.68] for PT in rLHL15, respectively. In rHUI, 0.21 (P = 0.508) [0.20, 0.23] for ALB, -0.59 (P = 0.045) [-0.60, -0.57] for BIL, and -0.29 (P = 0.362) [-0.30, -0.28] for PT, respectively.

Quantitative index for segmental liver reserve such as rHUI obtained from preoperative gadoxetate disodium-enhanced MR imaging predicts more precisely postoperative liver reserve in bilirubin metabolism, whereas rLHL15 obtained from preoperative 99mTc-GSA scintigraphy is superior to rHUI in the evaluation of postoperative liver reserve in protein synthesis.

Postoperative liver failure can be avoided by quantitative indices for segmental liver reserve such as rHUI and rLHL15 obtained from gadoxetate disodium-enhanced MR imaging and 99mTc-GSA scintigraphy.

Yanagisawa, S, Yamada, A, Tanaka, H, Fujii, S, Kurozumi, M, Fujinaga, Y, Ueda, K, Kadoya, M, Quantitative Evaluation of Postoperative Liver Reserve with Use of Gadoxetate Disodium-enhanced MR Imaging: Comparison with 99mTc-galactosyl Serum Albumin Scintigraphy.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043608.html