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Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
Patients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. The...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206118/ https://www.ncbi.nlm.nih.gov/pubmed/34131241 http://dx.doi.org/10.1038/s41598-021-92058-6 |
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author | Suzuki, Yuji Kakisaka, Keisuke Sato, Takuro Mikami, Ryouichi Abe, Hiroaki Sasaki, Tokio Takikawa, Yasuhiro |
author_facet | Suzuki, Yuji Kakisaka, Keisuke Sato, Takuro Mikami, Ryouichi Abe, Hiroaki Sasaki, Tokio Takikawa, Yasuhiro |
author_sort | Suzuki, Yuji |
collection | PubMed |
description | Patients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832–0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI. |
format | Online Article Text |
id | pubmed-8206118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-82061182021-06-16 Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury Suzuki, Yuji Kakisaka, Keisuke Sato, Takuro Mikami, Ryouichi Abe, Hiroaki Sasaki, Tokio Takikawa, Yasuhiro Sci Rep Article Patients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832–0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI. Nature Publishing Group UK 2021-06-15 /pmc/articles/PMC8206118/ /pubmed/34131241 http://dx.doi.org/10.1038/s41598-021-92058-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Suzuki, Yuji Kakisaka, Keisuke Sato, Takuro Mikami, Ryouichi Abe, Hiroaki Sasaki, Tokio Takikawa, Yasuhiro Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury |
title | Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury |
title_full | Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury |
title_fullStr | Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury |
title_full_unstemmed | Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury |
title_short | Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury |
title_sort | tc-99m gsa scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206118/ https://www.ncbi.nlm.nih.gov/pubmed/34131241 http://dx.doi.org/10.1038/s41598-021-92058-6 |
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