Evaluation of patients who underwent percutaneous transhepatic portal vein embolisation by Tc-99m GSA scintigraphy

Purpose
To analyse the correlation between the fold change in residual liver volume (RLV) and residual liver uptake at 15 (RLU15) before and after percutaneous transhepatic portal vein embolisation (PTPE).

Material and methods
Between August 2010 and December 2016, 20 patients who underwent PTPE were retrospectively selected. Before and three weeks after PTPE, contrast-enhanced computed tomography (CECT) and Tc-99m GSA scintigraphy were performed to analyse the fold changes in RLV and RLU15, respectively, as well as their correlation.

Results
After PTPE, a significant increase was observed in the RLV (before: 464 ± 99 ml; after: 573 ± 118 ml, p = 0.004) and the RLU15 (before: 11.0 ± 2.9%; after: 17.7 ± 3.8%, p = 5 × 10-7). The fold increase of RLV and RLU15 in all patients was 1.25 ± 0.15 and 1.66 ± 0.33, respectively. No significant correlation was observed in the fold increase in both RLV and RLU15 (r = 0.14, p = 0.66). In patients no. 3 and 9, who were outliers, the increase in RLV was minimal and RLU15 increased greatly, and these 2 patients underwent radical hepatectomy after PTPE.

Conclusions
No correlation was observed between the fold increase in RLV and RLU15 before and after PTPE. In order to accurately evaluate the residual liver function, it should be considered necessary to evaluate not only by morphological CECT volumetry, but also by functional outcome of Tc-99m GSA scintigraphy. Residual liver volume may not necessarily reflect RLF. It may be possible to improve the radical resection rate by detecting the potential increase of RLF with RLU15 of Tc-99m GSA scintigraphy.