TY - JOUR
T1 - Estimation of post-therapeutic liver reserve capacity using 99mTc-GSA scintigraphy prior to carbon-ion radiotherapy for liver tumors
AU - Yamazaki, Kana
AU - Nishii, Ryuichi
AU - Mizutani, Yoichi
AU - Makishima, Hirokazu
AU - Kaneko, Takashi
AU - Isobe, Yoshiharu
AU - Terada, Tamasa
AU - Tamura, Kentaro
AU - Imabayashi, Etsuko
AU - Tani, Toshiaki
AU - Kobayashi, Masato
AU - Wakatsuki, Masaru
AU - Tsuji, Hiroshi
AU - Higashi, Tatsuya
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/1
Y1 - 2023/1
N2 - Background: There is currently no established imaging method for assessing liver reserve capacity prior to carbon-ion radiotherapy (CIRT) for liver tumors. In order to perform safe CIRT, it is essential to estimate the post-therapeutic residual reserve capacity of the liver. Purpose: To evaluate the ability of pre-treatment 99mTc-galactosyl human serum albumin (99mTc-GSA) scintigraphy to accurately estimate the residual liver reserve capacity in patients treated with CIRT for liver tumors. Materials and methods: This retrospective study evaluated patients who were performed CIRT for liver tumors between December 2018 and September 2020 and underwent 99mTc-GSA scintigraphy before and 3 months after CIRT, and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI within 1 month before CIRT were evaluated. The maximal removal rate of 99mTc-GSA (GSA-Rmax) was analyzed for the evaluation of pre-treatment liver reserve capacity. Then, the GSA-Rmax of the estimated residual liver (GSA-RL) was calculated using liver SPECT images fused with the Gd-EOB-DTPA-enhanced MRI. GSA-RL before CIRT and GSA-Rmax at 3 months after CIRT were compared using non-parametric Wilcoxon signed-rank test and linear regression analysis. Results: Overall, 50 patients were included (mean age ± standard deviation, 73 years ± 11; range, 29–89 years, 35 men). The median GSA-RL was 0.393 [range, 0.057–0.729] mg/min, and the median GSA-Rmax after CIRT was 0.369 [range, 0.037–0.780] mg/min (P =.40). The linear regression equation representing the relationship between the GSA-RL and GSA-Rmax after CIRT was y = 0.05 + 0.84x (R2 = 0.67, P <.0001). There was a linear relationship between the estimated and actual post-treatment values for all patients, as well as in the group with impaired liver reserve capacity (y = − 0.02 + 1.09x (R2 = 0.62, P =.0005)). Conclusions: 99mTc-GSA scintigraphy has potential clinical utility for estimating the residual liver reserve capacity in patients undergoing carbon-ion radiotherapy for liver tumors. Trial registration: UMIN000038328, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043545.
AB - Background: There is currently no established imaging method for assessing liver reserve capacity prior to carbon-ion radiotherapy (CIRT) for liver tumors. In order to perform safe CIRT, it is essential to estimate the post-therapeutic residual reserve capacity of the liver. Purpose: To evaluate the ability of pre-treatment 99mTc-galactosyl human serum albumin (99mTc-GSA) scintigraphy to accurately estimate the residual liver reserve capacity in patients treated with CIRT for liver tumors. Materials and methods: This retrospective study evaluated patients who were performed CIRT for liver tumors between December 2018 and September 2020 and underwent 99mTc-GSA scintigraphy before and 3 months after CIRT, and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI within 1 month before CIRT were evaluated. The maximal removal rate of 99mTc-GSA (GSA-Rmax) was analyzed for the evaluation of pre-treatment liver reserve capacity. Then, the GSA-Rmax of the estimated residual liver (GSA-RL) was calculated using liver SPECT images fused with the Gd-EOB-DTPA-enhanced MRI. GSA-RL before CIRT and GSA-Rmax at 3 months after CIRT were compared using non-parametric Wilcoxon signed-rank test and linear regression analysis. Results: Overall, 50 patients were included (mean age ± standard deviation, 73 years ± 11; range, 29–89 years, 35 men). The median GSA-RL was 0.393 [range, 0.057–0.729] mg/min, and the median GSA-Rmax after CIRT was 0.369 [range, 0.037–0.780] mg/min (P =.40). The linear regression equation representing the relationship between the GSA-RL and GSA-Rmax after CIRT was y = 0.05 + 0.84x (R2 = 0.67, P <.0001). There was a linear relationship between the estimated and actual post-treatment values for all patients, as well as in the group with impaired liver reserve capacity (y = − 0.02 + 1.09x (R2 = 0.62, P =.0005)). Conclusions: 99mTc-GSA scintigraphy has potential clinical utility for estimating the residual liver reserve capacity in patients undergoing carbon-ion radiotherapy for liver tumors. Trial registration: UMIN000038328, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043545.
KW - Tc-GSA scintigraphy
KW - Carbon-ion radiotherapy
KW - GSA-RL
KW - GSA-Rmax
KW - Liver tumor
UR - https://www.scopus.com/pages/publications/85139205448
UR - https://www.scopus.com/pages/publications/85139205448#tab=citedBy
U2 - 10.1007/s00259-022-05985-5
DO - 10.1007/s00259-022-05985-5
M3 - Article
C2 - 36192469
AN - SCOPUS:85139205448
SN - 1619-7070
VL - 50
SP - 581
EP - 592
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 2
ER -