Modified prognosis scores with 99mTc-GSA SPECT scintigraphy in cases of portal vein embolization and after percutaneous transhepatic portal embolization

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Abstract

The significance of prognosis scores (PS) and modified prognosis scores (mPS), generated from CT volumetric analysis of hepatic resection rate (CTRR) and 99mTc-GSAFRR, in predicting a safe limit for resection was studied in patients who presented with hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (VP-HCC) in the main trunk. Preoperative percutaneous transhepatic portal vein embolization (PTPE) was performed in 14 patients. The values of 99mTc-GSAFRR were lower than those of CTRR in both VP-HCC and PTPE cases. In cases where the PS of the VP-HCC was in the critical range (≥55 points), whereas the mPS of another case was in the safe range (< 45 points) who underwent right hepatic resection or resection of the left inferior lateral subsegment; none showed postoperative hepatic paresis. In conclusion, it appears that in cases of VP-HCC and PTPE in which the prognosis of hepatic function is inhomogeneously distributed, it is advisable to refer not only to PS but also mPS obtained using 99mTc-GSAFRR when predicting the safe limit for resection.

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Atono, R., Ikuta, S., Aihara, T., Nakajima, T., & Yamanaka, N. (2016). Modified prognosis scores with 99mTc-GSA SPECT scintigraphy in cases of portal vein embolization and after percutaneous transhepatic portal embolization. Japanese Journal of Gastroenterological Surgery, 49(9), 926–931. https://doi.org/10.5833/jjgs.2015.0205

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