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Development of comprehensive diagnostic method, combining the assessment of liver perfusion and the assessment of hepatic cellular function, for predicting the liver function after hepatectomy

Research Project

Project/Area Number 17K10359
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Radiation science
Research InstitutionMie University

Principal Investigator

Ichikawa Yasutaka  三重大学, 医学部附属病院, 准教授 (80725127)

Co-Investigator(Kenkyū-buntansha) 中山 良平  立命館大学, 理工学部, 准教授 (20402688)
永田 幹紀  三重大学, 医学部附属病院, 講師 (40402028)
佐久間 肇  三重大学, 医学系研究科, 教授 (60205797)
市原 隆  藤田医科大学, 医学部, 教授 (90527748)
Project Period (FY) 2017-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Keywords肝機能 / パーフュージョン / CT / 99mTc-GSA / 肝機能シンチグラフィー / 肝予備能 / SPECT / 肝線維化 / 門脈血流 / パーフュージョンCT / 肝機能シンチグラフィ / 肝 / 動脈血流 / Tc-99m GSA肝受容体シンチ / 血流マップ / 放射線医学 / 肝血流
Outline of Final Research Achievements

In this study, liver perfusion CT protocol was optimized to achieve both high temporal resolution and low radiation dose exposure. With mathematical model, portal and arterial perfusion maps could be created separately. We developed a method to separate the intravascular component from the liver perfusion map based on the change in CT value, and to create a hepatic perfusion map that reflects the hepatic parenchymal perfusion with the removal of intravascular components. This method enables portal and arterial blood flow measurements in any region of the liver parenchyma. In addition, this study demonstrated that the uptake ratio of whole liver obtained by quantitative analysis of Tc-99m GSA SPECT/CT was significantly associated with the extent of pathological liver fibrosis. By using the liver uptake ratio on Tc-99m GSA SPECT/CT, severe liver fibrosis could be detected with a high sensitivity and specificity of approximately 90%.

Academic Significance and Societal Importance of the Research Achievements

本研究ではCTによる肝パーフュージョンや99mTc-GSA肝受容体分布を自動的に定量化するアルゴリズムを開発した。肝内血管成分を取り除いた肝血流マップを用いることで、任意の局所肝領域の血流を、門脈血流と動脈血流を別々に定量評価できる。本研究により、コンピュータ上で仮想的に肝切除線を設定し、肝切除後の残存肝容積、門脈血流量残存率、肝動脈血流量残存率、99mTc-GSAによる残肝機能をインターラクティブに予測評価するための基盤ができた。これらの新たな定量指標は、術後肝機能障害や術後合併症の予測する上で有用性が高い可能性があり、今後の臨床研究を行う上で重要な知見が得られたと考える。

Report

(4 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Research-status Report
  • 2017 Research-status Report
  • Research Products

    (3 results)

All 2019 2018

All Presentation (3 results) (of which Int'l Joint Research: 2 results)

  • [Presentation] Assessment of liver fibrosis with quantitative analysis of 99mTc-GSA SPECT/CT2019

    • Author(s)
      市川泰崇
    • Organizer
      第58回日本核医学会学術総会
    • Related Report
      2019 Annual Research Report
  • [Presentation] Assessment of Liver Fibrosis with Quantitative Analysis of Tc-99m Diethylenetriamine-pentaacetic Acid-galactosyl Human Serum Albumin (GSA) SPECT/CT: Comparison with Histopathological Fibrosis in Hepatectomy Specimen2019

    • Author(s)
      市川泰崇
    • Organizer
      Radiological Society of North America (RSNA, 105th annual meeting)
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Assessment of liver fibrosis with quantitative analysis of 99mTc-GSA SPECT/CT2018

    • Author(s)
      市川泰崇
    • Organizer
      Annual Congress of European Association of Nuclear Medicine (EANM'18)
    • Related Report
      2018 Research-status Report
    • Int'l Joint Research

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Published: 2017-04-28   Modified: 2021-02-19  

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