Toyama H, Ito K, Komori Y, Sugioka A, Shibata K, Komai S, Fujiwara T, Ishikawa E, Tomita K, Fujii N
Department of Radiology, Fujita Health University.
Kaku Igaku. 1995 Mar;32(3):323-9.
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.
99m锝-二乙三胺五乙酸-半乳糖基人血清白蛋白（99mTc-GSA）是一种新开发的肝脏显像配体，它能特异性结合肝细胞表面的去唾液酸糖蛋白受体。我们研究了99mTc-GSA闪烁扫描术是否能够作为肝切除术后肝细胞残余功能储备和早期再生的指标。对4例转移性肝癌患者、3例肝细胞癌患者和1例胆管细胞癌患者进行了研究。基本上，每位患者接受4次检查（术前、术后3天、10天、20天）。静脉注射185MBq（3mg）的99mTc-GSA后，立即获取系列图像和动态数据。分析肝切除术前和术后HH15（根据注射后15分钟心脏摄取率与3分钟时心脏摄取率的比值计算得出的示踪剂血液清除指标）和LHL15（根据注射后15分钟肝脏摄取率与肝脏加心脏摄取率的比值计算得出的肝脏摄取指标）的系列变化。4例接受肝叶切除术的患者中，有3例与术前数据相比HH15升高、LHL15降低，被认为残余肝功能储备降低。其余1例肝叶切除患者HH15升高，但LHL15反而升高。1例合并肝硬化的肝细胞癌行两次部分切除术的患者，HH15短暂降低，LHL15升高。2例转移性肝癌患者（1例部分切除术，6例部分切除术）HH15降低，LHL15升高。术后肝脏摄取增加被推测为功能性肝细胞增加或细胞表面去唾液酸糖蛋白受体因上调而短暂增加。99mTc-GSA闪烁扫描术可能有助于采用非侵入性方法检测肝切除术后肝细胞的残余功能储备和早期再生。
