Preoperative liver functional volumetry performed by 3D-^99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT: a preliminary study

Abstract

Aim: The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (^99mTc-GSA) scintigraphy/vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and functional volumetry.

Methods: The study group comprised 15 patients who underwent preoperative 3-dimensional (3D)-^99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy between July 2014 and August 2015. The diagnosis was hepatocellular carcinoma (n = 4), metastatic liver tumor (n = 10), or intrahepatic cholangiocarcinoma (n = 1). Right hepatectomy was performed in 2 patients, left hepatectomy in 3 patients, right posterior sectionectomy in 3 patients, segmentectomy in 2 patients, and partial hepatectomy in 4 patients. ^99mTc-GSA scintigraphy and computed tomography (CT) were performed to construct 3D-^99mTc-GSA scintigraphy/vascular fused images. The conventional volume ratio of the planned resection region without tumor (% CT), and the functional volume ratio of the planned resection region without tumor (% GSA) were calculated. The discrepancy ratio was calculated as follows: discrepancy ratio = 100 - % GSA/ % CT × 100 (%).

Results: The % GSA (17.9 ± 16.7%) was significantly lower than the % CT (21.5 ± 17.6%) (P < 0.036). In all except 2 patients, the % GSA was lower than the % CT. The discrepancy ratio ranged from -4% to 75% (median, 20.7%).

Conclusion: 3D-^99mTc-GSA scintigraphy/vascular fused images constructed using SYNAPSE VINCENT were useful for noninvasively performing functional liver volumetry in patients scheduled to undergo various patterns of hepatectomy. In planned resection regions without tumor, the functional volume ratio was about 20% lower than the conventional volume ratio.

Keywords

Functional volumetry / 99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin / SYNAPSE VINCENT / fusion image / 3-dimensional / computed tomography

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