Original Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2013; 19(21): 3217-3225
Published online Jun 7, 2013. doi: 10.3748/wjg.v19.i21.3217
CT/99mTc-GSA SPECT fusion images demonstrate functional differences between the liver lobes
Tatsuaki Sumiyoshi, Yasuo Shima, Ryoutarou Tokorodani, Takehiro Okabayashi, Akihito Kozuki, Yasuhiro Hata, Yoshihiro Noda, Yoriko Murata, Toshio Nakamura, Kiminori Uka
Tatsuaki Sumiyoshi, Yasuo Shima, Takehiro Okabayashi, Akihito Kozuki, Toshio Nakamura, Department of Gastroenterological Surgery, Kochi Health Sciences Center, Ike 2125, Kochi, Japan
Ryoutarou Tokorodani, Yasuhiro Hata, Yoshihiro Noda, Yoriko Murata, Department of Radiology, Kochi Health Sciences Center, Ike 2125, Kochi, Japan
Kiminori Uka, Department of Gastroenterology, Kochi Health Sciences Center, Ike 2125, Kochi, Japan
Author contributions: Sumiyoshi T, Shima Y, Tokorodani R, Okabayashi T, Kozuki A, Hata Y, Noda Y, Murata Y, Nakamura T and Uka K wrote the paper.
Correspondence to: Tatsuaki Sumiyoshi, MD, Department of Gastroenterological Surgery, Kochi Health Sciences Center, Ike 2125, Kochi, Japan. tasu050520@yahoo.co.jp
Telephone: +81-88-8373000 Fax: +81-88-8376766
Received: January 3, 2013
Revised: March 19, 2013
Accepted: April 9, 2013
Published online: June 7, 2013
Processing time: 151 Days and 20.8 Hours
Abstract

AIM: To evaluate the functional differences between the 2 liver lobes in non-cirrhotic patients by using computed tomography/99mTc-galactosyl human serum albumin (CT/99mTc-GSA) single-photon emission computed tomography (SPECT) fusion images.

METHODS: Between December 2008 and March 2012, 264 non-cirrhotic patients underwent preoperative liver function assessment using CT/99mTc-GSA SPECT fusion images. Of these, 30 patients, in whom the influence of a tumor on the liver parenchyma was estimated to be negligible, were selected. Specifically, the selected patients were required to meet either of the following criteria: (1) the presence of an extrahepatic tumor; or (2) presence of a single small intrahepatic tumor. These 30 patients were retrospectively analyzed to calculate the percentage volume (%Volume) and the percentage function (%Function) of each lobe. The ratio between the %Function and %Volume (function-to-volume ratio) of each lobe was also calculated, and the ratios were compared between the 2 lobes. Furthermore, the correlations between the function-to-volume ratio and each of 2 liver parameters [lobe volume and diameter ratio of the left portal vein to the right portal vein (LPV-to-RPV diameter ratio)] were investigated.

RESULTS: The median values of %Volume and %Function were 62.6% and 67.1% in the right lobe, with %Function being significantly higher than %Volume (P < 0.01). The median values of %Volume and %Function were 31.0% and 28.7% in the left lobe, with %Function being significantly lower than %Volume (P < 0.01). The function-to-volume ratios of the right lobe (1.04-1.14) were significantly higher than those of the left lobe (0.74-0.99) (P < 0.01). The function-to-volume ratio showed no significant correlation between the lobe volume in either lobe. In contrast, the function-to-volume ratio showed significant correlations with the LPV-to-RPV diameter ratio in both lobes (right lobe: negative correlation, rs = -0.37, P = 0.048; left lobe: positive correlation, rs = 0.71, P < 0.001). The function-to-volume ratio in the left lobe tended to be higher, and that in the right lobe tended to be lower, in accordance with the increase in the LPV-to-RPV diameter ratio.

CONCLUSION: CT/99mTc-GSA SPECT fusion images demonstrated that the function of the left lobe was significantly decreased compared with that of the right lobe in non-cirrhotic livers.

Keywords: Computed tomography; 99mTc neogalactoalbumin; Single-photon emission computed tomography; Fusion image; Liver; Portal system

Core tip: This study describes that lobular differences in tracer accumulation can be observed even in patients with an apparently homogeneous liver on 99mTc-galactosyl human serum albumin (99mTc-GSA) single-photon emission computed tomography (SPECT). computed tomography/99mTc-GSA SPECT fusion images demonstrated that the function of the left lobe was significantly decreased compared with that of the right lobe in non-cirrhotic livers.