technetium-tc-99m-mebrofenin and Colorectal-Neoplasms

Recently, there has been increasing interest in the preoperative prediction and prevention of post-hepatectomy liver failure (PHLF). This is a particular concern in colorectal liver metastases (CRLM), when surgery follows potentially hepatotoxic chemotherapy. Platelet-based liver scores (PBLS) such as APRI and FIB-4 are predictive of chemotherapy-associated liver injury (CALI) and PHLF. Estimation of the future liver remnant function (eFLRF) by combining. Between 2012 and 2016, 140 patients underwent liver resection for CRLM following systemic therapy. HBS. eFLRF and FLRV% had a better predictive value for PHLF than HBS. eFLRF is a better predictor of PHLF than PBLS or HBS

Topics: Aniline Compounds; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Colorectal Neoplasms; Female; Glycine; Hepatectomy; Humans; Imino Acids; Irinotecan; Liver Failure; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Organoplatinum Compounds; Organotechnetium Compounds; Oxaliplatin; Platelet Function Tests; Predictive Value of Tests; Radiopharmaceuticals; Treatment Outcome

Topics: Aged; Aged, 80 and over; Aniline Compounds; Colorectal Neoplasms; Combined Modality Therapy; Embolization, Therapeutic; Female; Gallbladder Neoplasms; Glycine; Hepatectomy; Humans; Imino Acids; Liver; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Portal Vein; Radiopharmaceuticals; Salvage Therapy; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

To correctly display the left and right liver lobe separately on dynamic projection scintigraphy, it is essential to adjust the collimator to the angle of the plane between the two liver lobes. We propose an optimized protocol for separating left and right liver lobe in (99m)Tc-mebrofenin hepatobiliary scintigraphy in a hybrid SPECT-CT device. The protocol uses the inherent attenuation correction low-dose CT (AC-CT) for individually adjusting gamma camera head angulation. The results of this protocol are compared with hypothetical results based on previous MRI, fixed angle, and traditional frontal projection.. The absolute and relative degrees of overlapping volume between left and right liver lobe parenchyma for frontal projection, 45° right anterior oblique (RAO) projection, RAO angulation based on previously acquired MRI, and RAO based on the AC-CT were measured in 14 patients who underwent (99m)Tc-mebrofenin hepatobiliary scintigraphy.. Relative degree of overlap was 31.3 ± 15.2 % for frontal projection, 8.2 ± 6.5 % for 45° RAO, 5.5 ± 3.5 % for RAO based on previous MRI, and 3.6 ± 2.5 % for RAO based on AC-CT. The relative overlap of RAO projections based on previous MRI was significantly lower than for frontal projection (p < 0.05). Use of the angle from the prior AC-CT, however, resulted in an even lower degree of overlap (p < 0.05).. Performing (99m)Tc-mebrofenin hepatobiliary scintigraphy using RAO detector alignment with an angle derived from a prior CT obtained in the SPECT-CT scanner can significantly reduce the degree of overlap between right and left liver lobe. If SPECT-CT is not available, previous CT or MRI or a fixed angle of 45° may be used.

Topics: Aged; Aged, 80 and over; Aniline Compounds; Colorectal Neoplasms; Female; Glycine; Humans; Imino Acids; Liver; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; Organotechnetium Compounds; Radiopharmaceuticals; Retrospective Studies; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed