A Novel Noninvasive Method for Predicting Liver Fibrosis by Quantifying the Estrangement of Indocyanine Green Retention Rate and Tc 99m diethylenetriamine penta acetic Acid galactosyl Human Serum Albumin Scintigraphy
Background/Aim: Indocyanine green (ICG) clearance test is one of the most popular dynamic methods for evaluating preoperative liver function to avoid posthepatectomy liver failure (PHLF) Tc 99m diethylenetriamine penta acetic acid galactosyl human serum albumin scintigraphy (GSA) also facilitates the direct estimation of functional hepatocytes and can estimate the ICG retention rate (R15) however, in some cases, there is a discrepancy between results of a preoperative examination of ICG R15 and the estimated ICG R15 obtained by 99mTc GSA (GSA R15) This study evaluated the gap between ICG R15 and GSA R15 (DICG) for predicting background liver fibrosis in patients who underwent hepatectomy. Patients and Methods: Sixty four consecutive patients who underwent hepatectomy and preoperative ICG R15 and GSA R15 examinations from 2016 to 2019 were retrospectively evaluated. The gap between GSA R15 and ICG R15 was defined as DICG and the factors predicting liver fibrosis were investigated. Results: In the pathologically proven cirrhotic group, platelet counts were significantly lower and DICG values were significantly larger than those in the non /early cirrhotic group. A multivariate analysis identified a higher total bilirubin level, a higher AST level, and a larger DICG level as significant predictive factors for liver cirrhosis. Conclusion: Larger DICG was found to be an independent preoperative predictor of liver fibrosis and may positively contribute to decision making before hepatectomy to avoid PHLF.
In Vivo