Decreased mebrofenin uptake in patients with non-colorectal liver tumors requiring liver volume augmentation-a...

Area of Science:

• Hepatobiliary surgery
• Nuclear medicine imaging
• Liver function assessment

Background:

• Posthepatectomy liver failure (PHLF) is a significant risk following liver resection.
• Accurate preoperative liver function assessment is vital to minimize PHLF.
• 99mTc-mebrofenin hepatobiliary scintigraphy with SPECT (MSPECT) is a tool for evaluating liver function.

Purpose of the Study:

• To compare the predictive value of MSPECT for PHLF in patients with non-colorectal liver tumors (NCRLT) versus colorectal liver metastasis (CRLM).
• To assess differences in mebrofenin uptake and future liver remnant (FLR) volume between NCRLT and CRLM patients undergoing extended liver resection.

Main Methods:

• Retrospective analysis of patients undergoing extended liver resections via two-stage procedures (January 2019 - December 2021).
• All included patients received preoperative MSPECT for liver function assessment.
• Comparison of PHLF rates, FLR volumes, and mebrofenin uptake between NCRLT and CRLM groups.

Main Results:

• Twenty patients were included; PHLF occurred in 25% (4 patients with grade C).
• No significant differences in PHLF rate or FLR volume were observed between NCRLT and CRLM groups.
• Patients with CRLM demonstrated significantly higher mebrofenin uptake in the FLR compared to NCRLT patients (2.49%/min/m² vs. 1.51%/min/m²; p=0.004).

Conclusions:

• Mebrofenin uptake is lower in NCRLT patients compared to CRLM patients.
• Despite differing uptake, PHLF rates and FLR volumes were comparable between the groups.
• Optimal mebrofenin uptake cut-off values for PHLF prediction may require adjustment based on surgical indication and disease type.