Significance of functional hepatic resection rate calculated using 3D CT/99mTc-galactosyl human serum albumin single-photon emission computed tomography fusion imaging

Figure 1 Creation of a 3D CT/^99mTc-galactosyl human serum albumin single-photon emission computed tomography fusion image using the Volume Analyzer SYNAPSE VINCENT. The resection line is set using the 3D image reconstructed from Digital Imaging and Communications in Medicine (DICOM) data obtained from multidetector CT, following which the acquired ^99mTc-GSA single-photon emission computed tomography (SPECT) image is fused with the 3D image. GSA: Galactosyl human serum albumin.

Figure 2 Correlation between the parenchymal hepatic resection rate and functional hepatic resection rate (calculated using 3D CT/^99mTc-galactosyl human serum albumin single-photon emission computed tomography fusion imaging. Functional hepatic resection rate (FHRR) is strongly correlated with parenchymal hepatic resection rate (PHRR).

Figure 3 Comparison of the ratio of the functional hepatic resection rate to the parenchymal hepatic resection rate between patients with preoperative therapies, macroscopic vascular invasion, and/or a tumor volume of > 1000 mL and those without these factors. The ratio is significantly smaller for patients with preoperative therapies (transcatheter arterial chemoembolization, radiation, radiofrequency ablation, etc.), a tumor volume of > 1000 mL, and/or macroscopic vascular invasion than for those without these factors (0.82 ± 0.18 vs 0.73 ± 0.19, P < 0.05).

Figure 4 Representative case of a 34-year-old woman diagnosed with a giant hemangioma scheduled to undergo right trisectionectomy. A: CT volumetry showing the tumor volume as 2818 mL and parenchymal hepatic resection rate as 80.0%; B: 3D CT/^99mTc-galactosyl human serum albumin single-photon emission computed tomography fusion image showing the functional hepatic resection rate as 60.8%. The patients underwent right trisectionectomy without preoperative portal vein embolization. She recovered without postoperative liver failure or any morbidity.