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Feasibility of Preoperative FDG PET/CT Total Hepatic Glycolysis in the Remnant Liver for the Prediction of Postoperative Liver Function

 Arthur Cho  ;  Yong Eun Chung  ;  Jin Sub Choi  ;  Kyung Sik Kim  ;  Gi Hong Choi  ;  Young Nyun Park  ;  Myeong-Jin Kim 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.208(3) : 624-631, 2017 
Journal Title
Issue Date
Female ; Fluorodeoxyglucose F18/pharmacokinetics* ; Glycolysis ; Hepatic Insufficiency/diagnostic imaging ; Hepatic Insufficiency/etiology* ; Hepatic Insufficiency/metabolism* ; Humans ; Image Interpretation, Computer-Assisted/methods ; Liver/diagnostic imaging ; Liver/metabolism ; Liver/surgery* ; Liver Function Tests/methods* ; Male ; Middle Aged ; Models, Biological ; Positron Emission Tomography Computed Tomography/methods* ; Postoperative Period ; Radiopharmaceuticals/pharmacokinetics ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Treatment Outcome
18F-FDG PET/CT ; hepatic insufficiency ; liver function ; total glycolysis
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. MATERIALS AND METHODS: Patients who underwent 18F-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 (SUVmean) 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. RESULTS: Of 149 patients, seven patients had hepatic insufficiency. The SUVmean 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 (Az) value (Az = 0.899) than SUVmean (0.659), MELD score (0.618), APRI (0.693), RFRHV (0.797), and remnant liver volume (0.762). 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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
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