Blood-pool SUV analysis of 99mTc-galactosyl human serum albumin (99mTc-GSA) normalized by blood volume for prediction of short-term survival in severe liver failure: preliminary report

Purpose

This study evaluated the usefulness of SUV analysis of 99mTc-galactosyl human serum albumin (99mTc-GSA) scintigraphy including SUV analysis of the cardiac blood pool normalized by blood volume as a predictor of short-term survival in severe liver failure.

Patients and methods

We enrolled 24 patients with severe liver failure who underwent 99mTc-GSA scintigraphy and were admitted to the intensive care unit. Patients were divided into survival and non-survival groups at 7, 14, and 28 days from the performance of 99mTc-GSA scintigraphy. From SPECT images we calculated SUVs of the cardiac blood pool, performing normalization for body weight, lean body weight, Japanese lean body weight, and blood volume and we calculated SUVs of the liver, normalizing by body weight, lean body weight, and Japanese lean body weight. We also calculated the uptake ratio of the heart at 15 min to that at 3 min (HH15) and the uptake ratio of the liver at 15 min to the liver plus the heart at 15 min (LHL15) from planar images of 99mTc-GSA scintigraphy.

Results

There were significant differences between the 7 day survival and non-survival groups for all SUVs of the heart and the liver and HH15, for 14 day survival groups in SUVs of the heart normalized by Japanese lean body weight and blood volume, and no significant differences between 28 day survival groups for any SUVs, HH15, or LHL15. Although the difference was not significant, SUV analysis of the heart normalized by blood volume showed the highest value for the area under the receiver-operating-characteristics curve for both 7 day and 14 day survival.

Conclusion

SUV analysis of 99mTc-GSA including SUV analysis of cardiac blood pool normalized by blood volume is of value for prediction of short-term survival in cases with severe liver failure.