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Original Article

Preoperative liver functional volumetry performed by

3D-99mTc-GSA scintigraphy/vascular fusion imaging using

SYNAPSE VINCENT: a preliminary study

Hiroshi Yoshida , Hiroshi Makino , Tadashi Yokoyama , Hiroshi Maruyama , Atsushi
1
1
1
1
Hirakata , Junji Ueda , Yasuhiro Mamada , Nobuhiko Taniai , Eiji Uchida 2
1
1
2
2
1 Department of Surgery, Nippon Medical School Tama Nagayama Hospital, Tokyo 206-8512, Japan.
2 Department of Surgery, Nippon Medical School, Tokyo 113-8603, Japan.
ABSTRACT
Aim: The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by
3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) scintigraphy/
vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and
functional volumetry. Methods: The study group comprised 15 patients who underwent preoperative 3-dimensional
(3D)-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy
between July 2014 and August 2015. The diagnosis was hepatocellular carcinoma (n = 4), metastatic liver tumor (n =
10), or intrahepatic cholangiocarcinoma (n = 1). Right hepatectomy was performed in 2 patients, left hepatectomy in 3
patients, right posterior sectionectomy in 3 patients, segmentectomy in 2 patients, and partial hepatectomy in 4 patients.
99mTc-GSA scintigraphy and computed tomography (CT) were performed to construct 3D-99mTc-GSA scintigraphy/
vascular fused images. The conventional volume ratio of the planned resection region without tumor (% CT), and the
functional volume ratio of the planned resection region without tumor (% GSA) were calculated. The discrepancy ratio
was calculated as follows: discrepancy ratio = 100 - % GSA/ % CT × 100 (%). Results: The % GSA (17.9 ± 16.7%)
was significantly lower than the % CT (21.5 ± 17.6%) (P < 0.036). In all except 2 patients, the % GSA was lower than
the % CT. The discrepancy ratio ranged from -4% to 75% (median, 20.7%). Conclusion: 3D-99mTc-GSA scintigraphy/
vascular fused images constructed using SYNAPSE VINCENT were useful for noninvasively performing functional liver
volumetry in patients scheduled to undergo various patterns of hepatectomy. In planned resection regions without tumor,
the functional volume ratio was about 20% lower than the conventional volume ratio.
Key words: Functional volumetry; 99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin;
SYNAPSE VINCENT; fusion image; 3-dimensional; computed tomography
Address for correspondence:
Dr. Hiroshi Yoshida, Department of Surgery, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama-city, Tokyo 206-8512,
Japan. E-mail: hiroshiy@nms.ac.jp
Received: 25-03-2016, Accepted: 29-03-2016

Hiroshi Yoshida, M.D., is graduated from Nippon Medical School (Bsc) obtained MD and subsequently entered the
Department of Surgery in 1986. From 1988 to 1992, He attended Postgraduate course in Department of Surgery, Nippon
Medical School and obtained PhD. In 2003, he was appointed assistant professor and, in 2005, associated professor of the
Department of Surgery, Nippon Medical School. In 2011, he was appointed Chief and Clinical Professor of the Department
of Surgery, Nippon Medical School Tama Nagayama Hospital. In 2016, he was appointed Director of the Nippon Medical
School Tama Nagayama Hospital.

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How to cite this article: Yoshida H, Makino H, Yokoyama T, Maruyama
H, Hirakata A, Ueda J, Mamada Y, Taniai N, Uchida E. Preoperative
DOI: liver functional volumetry performed by 3D-99mTc-GSA scintigraphy/
10.20517/2394-5079.2016.06 vascular fusion imaging using SYNAPSE VINCENT: a preliminary
study. Hepatoma Res 2016;2:187-92.

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