Japanese
Titleアシアロ糖タンパク受容体肝シンチグラフィによる肝切除術後の残存肝予備能と肝再生の評価
Subtitle技術報告
Authors外山宏*, 伊藤清信**, 小森義之***, 杉岡篤***, 柴田香織*, 駒井哲之*, 藤原寿照*, 石川恵美子*, 富田和美*, 藤井直子*, 蓮見昭武***, 江尻和隆*, 前田寿登*, 竹内昭*, 古賀佑彦*
Authors(kana)
Organization*藤田保健衛生大学医学部放射線医学教室, **北信総合病院放射線科, ***藤田保健衛生大学医学部消化器外科学教室
Journal核医学
Volume32
Number3
Page323-329
Year/Month1995/3
Article報告
Publisher日本核医学会
Abstract「要旨」大腸癌からの転移性肝腫瘍4例, 肝細胞癌3例, 胆管細胞癌1例の肝切除術前と, 検査可能な限り術後3回に99mTc-GSA肝シンチグラフィを行い, 残存肝予備能と肝再生の早期指標としての有用性について検討した. 肝葉切除4例中3例は術前と比べ, 術後HH15は上昇, LHL15は低下し残存肝予備能低下のためと考えられた. また, 部分切除術4症例のうち, 複数の部分切除を施行した肝硬変合併肝細胞癌の1症例に術後一時的なHH15の低下, LHL15の上昇, 転移性肝腫瘍のうち単発性切除の1例, 複数の部分切除の1例に術後HH15の低下, LHL15の上昇を認めた. 術後の肝集積の増加は, 肝細胞数の増加, 肝細胞表面受容体の一時的な増加など何らかの肝再生機転を示唆する所見と推定された. 99mTc-GSA肝シンチグラフィは, 肝切除術後早期の非侵襲的な残存肝予備能と肝再生の評価法として, 臨床的な有用性が期待された.
Practice臨床医学：一般
KeywordsTechnetium-99m-DTPA-galactosyl human serum albumin (99mTc-GSA), Asialoglycoprotein receptor imaging, Functional reserve, Regeneration, Hepatic resection
English
TitleEvaluation of the Residual Functional Reserve and the Early Regeneration after the Hepatic Resection Using Asialoglycoprotein Receptor Imaging Agent
Subtitle
AuthorsHiroshi TOYAMA*, Kiyonobu ITO**, Yoshiyuki KOMORI***, Atsushi SUGIOKA***, Kaori SHIBATA*, Satoshi KOMAI*, Toshiteru FUJIWARA*, Emiko ISHIKAWA*, Kazumi TOMITA*, Naoko FUJII*, Akitake HASUMI***, Kazutaka EJIRI*, Hisato MAEDA*, Akira TAKEUCHI*, Sukehiko KOGA*
Authors(kana)
Organization*Department of Radiology, Fujita Health University, **Department of Radiology, Hokushin General Hospital, ***First Department of Surgery, Fujita Health University
JournalThe Japanese Journal of nuclear medicine
Volume32
Number3
Page323-329
Year/Month1995/3
ArticleReport
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] 99mTc-DTPA-galactosyl human serum albumin (99mTc-GSA) is a newly developed liver imaging ligand which specifically binds to asialoglycoprotein receptor on the hepatic cell surface. We investigated whether 99mTc-GSA scintigraphy was able to be used as indexes for the residual functional reserve and the early regeneration of the hepatocyte after the hepatic resection. Four patients with metastatic liver cancer, 3 patients with hepatocellular carcinoma, and 1 patient with cholangiocellular carcinoma were studied. Basically, each patient was examined 4 times (before, 3, 10, 20 days after the operation). Immediately after i.v. injection of 185 MBq (3 mg) of 99mTc-GSA, serial images and dynamic data were obtained. Serial changes of HH15, as an index of blood clearance of the tracer calculated from the uptake ratio of heart at 15 minutes to that at 3 minutes, and LHL15, as an index of hepatic accumulation calculated from the uptake ratio of liver to liver plus heart at 15 minutes after the injection were analyzed before and after hepatectomy. Three out of 4 lobectomy patients which showed increased HH15, and decreased LHL15 as compared with the preoperative data were considered to be decreased residual hepatic functional reserve. The remaining one lobectomy patient showed increased HH15, but increased LHL15 inversely. One patient of two partial resections of hepatocellular carcinoma with liver cirrhosis demonstrated transiently decreased HH15, and increased LHL15. Two patients with metastatic liver cancer (one partial resection, six partial resections) showed decreased HH15, and increased LHL15. Postoperatively increased hepatic accumulation was presumed to be increased functioning hepatocyte or transiently increased asialoglycoprotein receptor on the cell surface by up-regulation. 99mTc-GSA scintigraphy might be helpful for non-invasive method to detect the residual functional reserve and the early regeneration of the hepatocyte after the hepatic resection.
PracticeClinical medicine
KeywordsTechnetium-99m-DTPA-galactosyl human serum albumin (99mTc-GSA), Asialoglycoprotein receptor imaging, Functional reserve, Regeneration, Hepatic resection

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