Introduction : Preoperative assessment of hepatic function of future remnant liver is still a major issue. We investigated the usefulness of measuring functional liver volume using 99mTc-galactosyl human serum albumin (GSA) scintigraphy single-photon emission computed tomography/computed tomography (SPECT/CT) imaging.

Methods : We performed a prospective analysis of 39 patients with colorectal liver metastases or hepatocellular carcinomas, underwent hepatic resection after portal vein embolization (PVE), and evaluated their functional liver volume perioperatively with GSA SPECT/CT. The percentage of the non-tumorous remnant liver volume (%LV) and the percentage of functional remnant liver volume (%FLV) were estimated. We have been using the prediction score (PS) (Yamanaka et al. Ann Surg. 1994; 219(4): 342-6） which was consists of %LV, indocyanine green retention rate, and patient’s age for predicting postoperative liver failure. We compared the PS and modified PS　(mPS) which adopted %FLV instead of %LV for prediction of postoperative liver failure using Area under receiver operatorating characteristic curve (AUC).

Results : The %LV increased significantly, from 40.3to 52.8%, and the increment was 12.5% (P

Conclusions : Accuracy of the prediction of the postoperative liver failure may be improved by FLV using GSA SPECT/CT.