• Masahiko Taniguchi, Atsutaka Okizaki, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Noriyuki Shuke, Naoyuki Miyokawa, and Hiroyuki Furukawa.
• Masahiko Taniguchi, Kenji Watanabe, Koji Imai, Koichiro Uchida, Takahiro Einama, Hiroyuki Furukawa, Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical College, Asahikawa 078-8510, Japan.
• World J. Gastroenterol. 2014 Nov 28; 20 (44): 16714-20.

AimTo evaluate the clinical utility of hepatic clearance (HC) measured with technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl human serum albumin ((99m)Tc-GSA) single-photon emission computed tomography (SPECT) to estimate the degree of liver fibrosis.MethodsSeventy-eight consecutive patients who underwent initial hepatectomy due to hepatocellular carcinoma were enrolled in this study. Indocyanine green clearance (ICG R15), quantitative indices estimated by (99m)Tc-GSA [the receptor index (LHL15 and HH15) and HC via SPECT analysis], and conventional liver function tests were performed before hepatectomy. Correlations among the quantitative indices for liver functional reserve, conventional liver function tests, and the degree of liver fibrosis were evaluated.ResultsThe degree of liver fibrosis was correlated with ICG R15, HH15, LHL15, and HC. HC showed the best correlation with conventional liver function tests. According to multivariate analysis, HC and LHL15 were significant independent predictors of severe fibrosis. HC was the most valuable index for predicting severe fibrosis.ConclusionHC measured with (99m)Tc-GSA SPECT is a reliable index for assessing liver fibrosis before hepatectomy.

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