Functional hepatic volume measured by technetium-99m-galactosyl-human serum albumin liver scintigraphy: Comparison between hepatocyte volume and liver volume by computed tomography

OBJECTIVES: We investigated the usefulness of measuring the functional hepa tic volume by single-photon emission CT with 99m-technetium galactosyl-huma n serum albumin scintigraphy (GSA-LV). We then compared this value to the t otal hepatocyte volume and the hepatic volume determined from CT (CT-LV) in the patients with hepatobiliary tumors. METHODS: Forty-seven patients were divided into two groups, the SM group (s ubsegmentectomy and monosegmentectomy) and the DT group (disegmentectomy an d trisegmentectomy). These groups were further divided into subgroups with or without chronic hepatitis or cirrhosis. The GSA-LV, CT-LV, and the total hepatocyte volume were then calculated. The GSA-LV and CT-LV measurements were performed preoperatively, at 2 and 4 wk, and at 3 and 6 months after s urgery. RESULTS: The preoperative GSA-LV values were significantly correlated with the hepatocyte volume and the 15-min retention rate of indocyanine green (I CGR15). Similarly, the hepatocyte volume correlated well with the CT-LV and ICGR15. However, the CT-LV was correlated only with the ICGR15. Recovery o f the GSA-LV in the DT group was delayed, and about 90% of the volumetric a nd functional regeneration was observed within 6 months after the hepatecto my. In contrast, the CT-LV of DT group patients with normal liver remnants returned to approximately 90% of their initial volume within 1 month after the hepatectomy whereas patients with injured livers regenerated gradually and regained approximately 80% of their preoperative value by 6 months afte r the hepatectomy. CONCLUSIONS: We conclude that the measurement of functional hepatic volume using the GSA-LV is useful in fully evaluating hepatic function based on he patocyte volume.