Tumor Radioactivity in 99mTc-GSA Scintigraphy Predicts Oncological Outcomes in Patients Who Underwent Hepatectomy for Hepatocellular Carcinoma.

Abstract

Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) scintigraphy is used as a preoperative liver reserve test. This study investigated whether tumor radioactivity in 99mTc-GSA scintigraphy correlates with the survival of patients with hepatocellular carcinoma (HCC). In total, 115 patients who underwent 99mTc-GSA scintigraphy before hepatectomy for HCC were included in this study. Tumor radioactivity in 99mTc-GSA scintigraphy was assessed, and its prognostic relevance to disease-free survival (DFS) and overall survival (OS) in patients with HCC was evaluated. The hepatic uptake index in 99mTc-GSA scintigraphy was associated with liver fibrosis. HCC with high tumor radioactivity in 99mTc-GSA scintigraphy showed high expression of the asialoglycoprotein receptor. Tumor radioactivity in 99mTc-GSA scintigraphy was associated with histologic differentiation grade and tumor size. Low tumor radioactivity was identified as an independent poor prognostic predictor of both DFS and OS. 99mTc-GSA scintigraphy may be valuable not only for evaluating hepatic function before hepatectomy for HCC but also for assessing the aggressive biology of a tumor.