Devised a new preoperative simulation using ^99mTc-GSA SPECT quantitative method for live resection

We developed a new imaging method to assess liver function by analyzing the amount of liver asialo single photon emission computed tomography (SPECT) using technetium-99m diethylenetriamine pentaacetic acid galactosyl human serum albumin (^99mTC-GSA) injection. A preoperative simulation using various regions of interest (ROIs) was performed, and the usefulness of the method for predicting the residual liver function was examined. Ninety-three patients were enrolled who underwent both asialo scintigraphy and dynamic computed tomography (CT) scanning. The two-dimensional dynamic data were analyzed using the Patlak plot method to calculate Kup and perfusion index (PI). The PIi (the quantity of GSA in a reference slice) was calculated using the PI. The qualitative SPECT data were analyzed using quantitative images and the PIi, and we calculated the amount of asialo uptake per unit, which we named asialo uptake index (AUI). Volume registration was done between the collected breath holding SPECT data and CT images. We were able to obtain AUI images and calculate the liver sparing ability by analyzing the two-dimensional data. The AUI and each of the liver counts (HH15, LHL15, LUI15 and PI) were correlated, and we could perform the preoperative simulation using any ROI. Preoperative simulation for the outcome of hepatectomy could be done using new method employing quantitative SPECT. (author)