Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99m Tc-GSA SPECT fusion images correlates well with postoperative liver function parameters
Preoperative estimation of asialoglycoprotein receptor expression in the remnant liver from CT/99m Tc-GSA SPECT fusion images correlates well with postoperative liver function parameters
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DOI：
10.1007/s00534-010-0264-6
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发表时间：
2010-09-01
影响因子：
3
通讯作者：
Fujimoto, Jiro
中科院分区：
文献类型：
--
作者：
Iimuro, Yuji;Kashiwagi, Toru;Fujimoto, Jiro
背景术前准确评估残肝功能对于肝脏手术至关重要，而脱唾液酸糖蛋白受体(ASGPR)的表达与肝功能相关。方法以32例接受手术切除的肝细胞癌患者为研究对象。为了估计残肝中 ASGPR 的表达，对融合图像进行了模拟手术，该融合图像结合了 (99m) 锝-半乳糖基人血清白蛋白 (Tc-99m-GSA)/单光子发射计算机断层扫描 (SPECT) 和计算机断层扫描 (CT) 扫描的数据。预测Tc-99m-GSA的肝脏摄取率（LUR）和残肝的功能性肝体积（FLV），并与术后肝功能参数进行比较。结果Tc-99m-GSA的LUR与肝脏ASGPR表达程度强相关（r = 0.944，p = 5.01 x 10(-16)），证实为 评估肝功能的可靠参数。估计的残余 LUR（而不是估计的残余 FLV）与术后肝功能参数显着相关，例如 1 周时的血清总胆红素（r = -0.430，p < 0.05）、凝血酶原活性（r = 0.515，p < 0.01）和血清胆碱酯酶活性（r = 0.546，p < 0.01）。结论 术前在 CT/GSA-SPECT 融合图像上估计残肝中 ASGPR 表达的程度与术后肝功能参数密切相关，表明其对手术决策的有用性。
Background Accurate preoperative estimation of remnant liver function is critically important for hepatic surgery, and the expression of asialoglycoprotein receptors (ASGPR) is associated with hepatic function.Methods Thirty-two patients with hepatocellular carcinoma who underwent surgical resection were studied. To estimate the expression of ASGPR in the remnant liver, simulated surgery was performed on fusion images that combined data from (99m)technetium-galactosyl human serum albumin (Tc-99m-GSA)/single photon emission computed tomography (SPECT) and computed tomography (CT) scanning. The liver uptake ratio (LUR) of Tc-99m-GSA and the functional liver volume (FLV) in the remnant liver were predicted and were compared with postoperative liver function parameters.Results The LUR of Tc-99m-GSA was strongly correlated with the extent of hepatic ASGPR expression (r = 0.944, p = 5.01 x 10(-16)), being confirmed to be a reliable parameter for the evaluation of liver function. The estimated remnant LUR, but not the estimated remnant FLV, was significantly correlated with postoperative liver function parameters, such as serum total bilirubin (r = -0.430, p < 0.05), prothrombin activity (r = 0.515, p < 0.01), and serum cholinesterase activity (r = 0.546, p < 0.01) at 1 week.Conclusion Preoperative estimation of the extent of ASGPR expression in the remnant liver on CT/GSA-SPECT fusion images correlated well with postoperative liver function parameters, suggesting its usefulness for surgical decisions.