Clearance of the liver remnant predicts short-term outcome in patients undergoing resection of hepatocellular carcinoma

Figure 1 Schematic model for analysis of regional hepatic clearance with computed tomography fusion images. The images of ^99mTc-galactosyl serum albumin scintigraphy single photon emission computed tomography and computed tomography scans were merged using software. The cutting line was set based on tumor location and size on each fusion image. The liver function was calculated automatically as ^99mTc-galactosyl serum albumin scintigraphy parameters. CT: Computed tomography; SPECT: Single photon emission computed tomography.

Figure 2 Analysis of hepatic clearance for post hepatectomy liver failure. A: Receiver-operating characteristic curve analysis of hepatic clearance of the remnant liver, LHL15, and albumin–bilirubin (ALBI) score in predicting PHLF. The area under the receiver-operating characteristic curve values for analysis of hepatic clearance of the remnant liver, LHL15, and ALBI score in predicting PHLF were 0.868, 0.629, and 0.655, respectively; B: Hepatic clearance of the remnant liver for each PHLF. The median hepatic clearances of the remnant liver were 239, 153, 150.5, and 119.5 mL/min for normal, Grades A, B, and C, respectively. LHL15: liver to heart-plus-liver radioactivity at 15 min; ALBI score: Albumin–bilirubin score; PHLF: Post hepatectomy liver failure.

Figure 3 Analysis of hepatic clearance for morbidity and mortality. A: Receiver operating characteristic curve analysis of hepatic clearance of the remnant liver, LHL15, and albumin–bilirubin (ALBI) score in predicting major morbidity. The area under the receiver operating characteristic curve analysis of hepatic clearance of the remnant liver, LHL15, and ALBI score in predicting major morbidity were 0.758, 0.594, and 0.647, respectively; B: Hepatic clearance of the remnant liver for Clavien–Dindo classification. The median hepatic clearances of the remnant liver were 238 and 179 mL/min for Clavien–Dindo < III and Clavien–Dindo ≥ III. LHL15: liver to heart-plus-liver radioactivity at 15 min; ALBI score: Albumin–bilirubin score.