ISSN: 1899-0967
Polish Journal of Radiology
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vol. 83
Original paper

Evaluation of patients who underwent percutaneous transhepatic portal vein embolisation by Tc-99m GSA scintigraphy

Norifumi Kennoki, Kiyoshi Koizumi, Koichi Tomita, Tomohisa Moriya, Jun Otaka, Kunihito Suzuki, Toru Saguchi, Naokazu Chiba, Shigeyuki Kawachi, Hiromi Serizawa

© Pol J Radiol 2018; 83: e543-e553
Online publish date: 2018/12/15
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To analyse the correlation between the fold change in residual liver volume (RLV) and residual liver uptake at 15 (RLU15) before and after percutaneous transhepatic portal vein embolisation (PTPE).

Material and methods
Between August 2010 and December 2016, 20 patients who underwent PTPE were retrospectively selected. Before and three weeks after PTPE, contrast-enhanced computed tomography (CECT) and Tc-99m GSA scintigraphy were performed to analyse the fold changes in RLV and RLU15, respectively, as well as their correlation.

After PTPE, a significant increase was observed in the RLV (before: 464 ± 99 ml; after: 573 ± 118 ml, p = 0.004) and the RLU15 (before: 11.0 ± 2.9%; after: 17.7 ± 3.8%, p = 5 × 10-7). The fold increase of RLV and RLU15 in all patients was 1.25 ± 0.15 and 1.66 ± 0.33, respectively. No significant correlation was observed in the fold increase in both RLV and RLU15 (r = 0.14, p = 0.66). In patients no. 3 and 9, who were outliers, the increase in RLV was minimal and RLU15 increased greatly, and these 2 patients underwent radical hepatectomy after PTPE.

No correlation was observed between the fold increase in RLV and RLU15 before and after PTPE. In order to accurately evaluate the residual liver function, it should be considered necessary to evaluate not only by morphological CECT volumetry, but also by functional outcome of Tc-99m GSA scintigraphy. Residual liver volume may not necessarily reflect RLF. It may be possible to improve the radical resection rate by detecting the potential increase of RLF with RLU15 of Tc-99m GSA scintigraphy.


PTPE, Tc-99m GSA scintigraphy, LU15, future remnant liver, sinusoidal obstructive syndrome, chemotherapy-associated steatohepatitis

Shindoh J, Tzeng CW, Aloia TA, et al. Safety and efficacy of portal vein embolization before planned major or extended hepatectomy: an institutional experience of 358 patients. J Gastrointest Surg 2014; 18: 45-51.
Chiba N, Shimazu M, Takano K, et al. Predicting hepatic failure with a new diagnostic technique by preoperative liver scintigraphy and computed tomography: a pilot study in 123 patients undergoing liver resection. Patient Saf Surg 2017; 11: 29.
Yumoto Y, Yagi T, Sato S, et al. Preoperative estimation of remnant hepatic function using fusion images obtained by 99mTc‐labelled galactosyl‐human serum albumin liver scintigraphy and computed tomography. Br J Surg 2010; 97: 934-944.
Kokudo N, Vera DR, Koizumi M, et al. Recovery of hepatic asialoglycoprotein receptors after major hepatic resection. J Nucl Med 1999; 40: 137-141.
Wu J, Ishikawa N, Takeda T, et al. The functional hepatic volume assessed by 99m Tc-GSA hepatic scintigraphy. Ann Nucl Med 1995; 9: 229-235.
Mitsumori A, Nagaya I, Kimoto S, et al. Preoperative evaluation of hepatic functional reserve following hepatectomy by technetium-99m galactosyl human serum albumin liver scintigraphy and computed tomography. Eur J Nucl Med 1998; 25: 1377-1382.
Kasai Y, Hatano E, Iguchi K, et al. Prediction of the remnant liver hypertrophy ratio after preoperative portal vein embolization. Eur Surg Res 2013; 51: 129-137.
Kono Y, Kariya S, Komemushi A, et al. Comparison of Tc-99m GSA scintigraphy and CT volumetry for evaluation in portal vein embolization. Minim Invasive Ther Allied Technol 2014; 23: 241-246.
Koizumi K, Uchiyama G, Arai T, et al. A new liver functional study using Tc-99m DTPA-galactosyl human serum albumin: evaluation of the validity of several functional parameters. Ann Nucl Med 1992; 6: 83-87.
Uetake M, Koizumi K, Yagawa A, et al. Use of Tc-99m DTPA galactosyl human serum albumin to predict postoperative residual liver function. Clin Nucl Med 1999; 24: 428-434.
Satake M, Hayashi T, Iwata R, et al. Percutaneous transhepatic portal vein embolization using absolute ethanol. Nichidoku-Iho 2007; 52: 94-99. (Japanese)
Desmet VJ, Gerber M, Hoofnagle JH, et al. Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 1994; 19: 1513-1520.
Rubbia-Brandt L, Audard V, Sartoretti P, et al. Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. Ann Oncol 2004; 15: 460-466.
Nishiyama Y, Yamamoto Y, Hino I, et al. 99mTc galactosyl human serum albumin liver dynamic SPET for pre‐operative assessment of hepatectomy in relation to percutaneous transhepatic portal embolization. Nucl Med Commun 2003; 24: 809-817.
Nanashima A, Tobinaga S, Abo T, et al. 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. J Surg Res 2010; 164: e235-e242.
Farges O, Belghiti J, Kianmanesh R, et al. Portal vein embolization before right hepatectomy: prospective clinical trial. Ann Surg 2003; 237: 208-217.
Van Lienden KP, Van den Esschert JW, De Graaf W, et al. Portal vein embolization before liver resection: a systematic review. Cardiovasc Intervent Radiol 2013; 36: 25-34.
Cotroneo AR, Innocenti P, Marano G, et al. Pre-hepatectomy portal vein embolization: single center experience. Eur J Surg Oncol 2009; 35: 71-78.
Ko GY, Sung KB, Yoon HK, et al. Preoperative portal vein embolization with a new liquid embolic agent. Radiology 2003; 227: 407-413.
Zorzi D, Chun YS, Madoff DC, et al. Chemotherapy with bevacizumab does not affect liver regeneration after portal vein embolization in the treatment of colorectal liver metastases. Ann Surg Oncol 2008; 15: 2765-2772.
Covey AM, Brown KT, Jarnagin WR, et al. Combined portal vein embolization and neoadjuvant chemotherapy as a treatment strategy for resectable hepatic colorectal metastases. Ann Surg 2008; 247: 451-455.
de Baere T, Teriitehau C, Deschamps F, et al. Predictive factors for hypertrophy of the future remnant liver after selective portal vein embolization. Ann Surg Oncol 2010; 17: 2081-2089.
Narita M, Oussoultzoglou E, Chenard MP, et al. Sinusoidal obstruction syndrome compromises liver regeneration in patients undergoing two-stage hepatectomy with portal vein embolization. Surg Today 2011; 41: 7-17.
Sakuhara Y, Abo D, Hasegawa Y, et al. Preoperative percutaneous transhepatic portal vein embolization with ethanol injection. AJR Am J Roentgenol 2012; 198: 914-922.
Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg 2008; 247: 49-57.
Di Stefano DR, de Baere T, Denys A, et al. Preoperative percutaneous portal vein embolization: evaluation of adverse events in 188 patients. Radiology 2005; 234: 625-630.
Kodama Y, Shimizu T, Endo H, et al. Complications of percutaneous transhepatic portal vein embolization. J Vasc Interv Radiol 2002; 13: 1233-1237.
Giraudo G, Greget M, Oussoultzoglou E, et al. Preoperative contralateral portal vein embolization before major hepatic resection is a safe and efficient procedure: a large single institution experience. Surgery 2008; 143: 476-482.
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