Back to Search
Start Over
Feasibility of Preoperative FDG PET/CT Total Hepatic Glycolysis in the Remnant Liver for the Prediction of Postoperative Liver Function.
- Source :
-
AJR. American journal of roentgenology [AJR Am J Roentgenol] 2017 Mar; Vol. 208 (3), pp. 624-631. Date of Electronic Publication: 2016 Dec 27. - Publication Year :
- 2017
-
Abstract
- Objective: The objective of our study was to investigate the prognostic value of total glycolysis of the remnant liver, which reflects both metabolic and anatomic liver function, for predicting postoperative hepatic insufficiency.<br />Materials and Methods: Patients who underwent <superscript>18</superscript> F-FDG PET/CT and abdominal CT within 1 month of major hepatectomy were retrospectively analyzed. Total liver volume, remnant liver volume, the ratio of the remnant hepatic volume to the preoperative hepatic volume (RFRHV), and mean standardized uptake value (SUV <subscript>mean</subscript> ) were measured, and total glycolysis of the remnant liver was calculated. Clinical hepatic function reserve values, including the indocyanine green retention rate at 15 minutes, the model for end-stage liver disease (MELD) score, and aspartate aminotransferase to platelet ratio index (APRI), were calculated. Univariate and multivariate analyses were performed, and an optimal model for predicting hepatic insufficiency was developed. ROC curves were used to compare diagnostic performance.<br />Results: Of 149 patients, seven patients had hepatic insufficiency. The SUV <subscript>mean</subscript> showed the highest sensitivity (100%; specificity, 31.7%) for predicting hepatic insufficiency, and total glycolysis of the remnant liver showed the highest specificity (96.5%; sensitivity, 57.1%) for predicting hepatic insufficiency. On multivariate analysis, the odds ratio of APRI (> 5.4) and total glycolysis of the remnant liver (≤ 625.6) was 46.3 and 82.9, respectively, for predicting hepatic insufficiency. On ROC curve analysis, a new model composed of APRI and total glycolysis of the remnant liver showed a higher area under the ROC curve (A <subscript>z</subscript> ) value (A <subscript>z</subscript> = 0.899) than SUV <subscript>mean</subscript> (0.659), MELD score (0.618), APRI (0.693), RFRHV (0.797), and remnant liver volume (0.762).<br />Conclusion: The total glycolysis of the remnant liver has moderate sensitivity and high specificity for predicting hepatic insufficiency. Combining the total glycolysis of the remnant liver and APRI yielded the best diagnostic performance for predicting hepatic insufficiency.
- Subjects :
- Female
Glycolysis
Hepatic Insufficiency diagnostic imaging
Humans
Image Interpretation, Computer-Assisted methods
Liver diagnostic imaging
Liver metabolism
Male
Middle Aged
Models, Biological
Postoperative Period
Radiopharmaceuticals pharmacokinetics
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Treatment Outcome
Fluorodeoxyglucose F18 pharmacokinetics
Hepatic Insufficiency etiology
Hepatic Insufficiency metabolism
Liver surgery
Liver Function Tests methods
Positron Emission Tomography Computed Tomography methods
Subjects
Details
- Language :
- English
- ISSN :
- 1546-3141
- Volume :
- 208
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- AJR. American journal of roentgenology
- Publication Type :
- Academic Journal
- Accession number :
- 28026972
- Full Text :
- https://doi.org/10.2214/AJR.16.16450