Dynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective study

Abstract Background At least 20% of the future liver remnant must function properly after liver tumor resection to avoid post-hepatectomy liver failure (PHLF). [99mTc]Tc-mebrofenin scintigraphy and SPECT are unique noninvasive, quantitative methods for evaluating liver function via hepatocellular bi...

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Main Authors: Annamária Bakos, László Libor, Szabolcs Urbán, Tibor Géczi, Mátyás Bukva, József Hőhn, György Lázár, András Nagy, István Farkas, Gábor Sipka, László Pávics, Zsuzsanna Besenyi
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Language:English
Published: Nature Portfolio 2024-12-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-81331-z
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author Annamária Bakos
László Libor
Szabolcs Urbán
Tibor Géczi
Mátyás Bukva
József Hőhn
György Lázár
András Nagy
István Farkas
Gábor Sipka
László Pávics
Zsuzsanna Besenyi
author_facet Annamária Bakos
László Libor
Szabolcs Urbán
Tibor Géczi
Mátyás Bukva
József Hőhn
György Lázár
András Nagy
István Farkas
Gábor Sipka
László Pávics
Zsuzsanna Besenyi
author_sort Annamária Bakos
collection DOAJ
description Abstract Background At least 20% of the future liver remnant must function properly after liver tumor resection to avoid post-hepatectomy liver failure (PHLF). [99mTc]Tc-mebrofenin scintigraphy and SPECT are unique noninvasive, quantitative methods for evaluating liver function via hepatocellular bilirubin clearance. Aim To evaluate the value of dynamic [99mTc]Tc-mebrofenin SPECT/CT parameters for predicting clinically relevant PHLF according to the ISGLS criteria. Methods Thirty-five patients underwent dynamic [99mTc]Tc-mebrofenin SPECT/CT imaging to determine the FLR volumetric rate, functional volume rate, total liver filtration and FLR filtration. On the same day, two-dimensional ultrasound shear wave elastography (2D-SWE) was used to assess parenchymal fibrosis in the FLR. The quantitative dynamic SPECT parameters were compared with the relevant clinical scores and ICG. Results The total liver filtration was inversely correlated with the ICG-R15 and MELD-Na score. Twenty-four patients underwent major liver resection due to an adequate FLR rate and did not die within 90 days after the procedure. ROC analysis revealed that the FLR filtration was a significant predictor of PHLF. The best cutoff value for FLR filtration was 2.72%/min/m2. Conclusion Dynamic [99mTc]Tc-mebrofenin SPECT/CT is an essential tool for selecting patients at risk of clinically relevant PHLF after liver resection.
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spelling doaj-art-c8b3209912bf45ae8cf4e1214c9cb28f2024-12-08T12:25:36ZengNature PortfolioScientific Reports2045-23222024-12-0114111210.1038/s41598-024-81331-zDynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective studyAnnamária Bakos0László Libor1Szabolcs Urbán2Tibor Géczi3Mátyás Bukva4József Hőhn5György Lázár6András Nagy7István Farkas8Gábor Sipka9László Pávics10Zsuzsanna Besenyi11Department of Nuclear Medicine, University of SzegedDepartment of Surgery, University of SzegedDepartment of Nuclear Medicine, University of SzegedDepartment of Surgery, University of SzegedDepartment of Immunology, Albert Szent-Györgyi Medical School, Faculty of Science and Informatics, University of SzegedDepartment of Surgery, University of SzegedDepartment of Surgery, University of SzegedDepartment of Radiology, University of SzegedDepartment of Nuclear Medicine, University of SzegedDepartment of Nuclear Medicine, University of SzegedDepartment of Nuclear Medicine, University of SzegedDepartment of Nuclear Medicine, University of SzegedAbstract Background At least 20% of the future liver remnant must function properly after liver tumor resection to avoid post-hepatectomy liver failure (PHLF). [99mTc]Tc-mebrofenin scintigraphy and SPECT are unique noninvasive, quantitative methods for evaluating liver function via hepatocellular bilirubin clearance. Aim To evaluate the value of dynamic [99mTc]Tc-mebrofenin SPECT/CT parameters for predicting clinically relevant PHLF according to the ISGLS criteria. Methods Thirty-five patients underwent dynamic [99mTc]Tc-mebrofenin SPECT/CT imaging to determine the FLR volumetric rate, functional volume rate, total liver filtration and FLR filtration. On the same day, two-dimensional ultrasound shear wave elastography (2D-SWE) was used to assess parenchymal fibrosis in the FLR. The quantitative dynamic SPECT parameters were compared with the relevant clinical scores and ICG. Results The total liver filtration was inversely correlated with the ICG-R15 and MELD-Na score. Twenty-four patients underwent major liver resection due to an adequate FLR rate and did not die within 90 days after the procedure. ROC analysis revealed that the FLR filtration was a significant predictor of PHLF. The best cutoff value for FLR filtration was 2.72%/min/m2. Conclusion Dynamic [99mTc]Tc-mebrofenin SPECT/CT is an essential tool for selecting patients at risk of clinically relevant PHLF after liver resection.https://doi.org/10.1038/s41598-024-81331-z[99mTc]Tc-mebrofeninHepatectomyLiver failureVolumetryLiver functionHepatocyte
spellingShingle Annamária Bakos
László Libor
Szabolcs Urbán
Tibor Géczi
Mátyás Bukva
József Hőhn
György Lázár
András Nagy
István Farkas
Gábor Sipka
László Pávics
Zsuzsanna Besenyi
Dynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective study
Scientific Reports
[99mTc]Tc-mebrofenin
Hepatectomy
Liver failure
Volumetry
Liver function
Hepatocyte
title Dynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective study
title_full Dynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective study
title_fullStr Dynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective study
title_full_unstemmed Dynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective study
title_short Dynamic [99mTc]Tc-mebrofenin SPECT/CT in preoperative planning of liver resection: a prospective study
title_sort dynamic 99mtc tc mebrofenin spect ct in preoperative planning of liver resection a prospective study
topic [99mTc]Tc-mebrofenin
Hepatectomy
Liver failure
Volumetry
Liver function
Hepatocyte
url https://doi.org/10.1038/s41598-024-81331-z
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