99m-Technetium galactosyl human serum albumin scanning to evaluate liver function after stereotactic body radiotherapy for hepatocellular carcinoma: A case report

The primary choice among treatment options for liver malignancies is surgery. However, if surgery cannot be performed, Stereotactic body radiotherapy (SBRT) may be effective. 99m-technetium galactosyl human serum albumin (GSA) single-photon emission computed tomography (SPECT) imaging is useful for the assessment of liver function before surgery. We report the case of a 77-year-old man who had undergone SBRT for hepatocellular carcinoma of the left lobe of the liver 2 years previously. Follow-up revealed a 15-mm hepatocellular carcinoma at the edge of the right lobe of the liver. 99m-technetium GSA SPECT was performed before SBRT to confirm that there was no accumulation in the left lobe and to ensure that there was good function of the right lobe. Three months after SBRT, the tumor had responded, and decreases in GSA accumulation were observed in line with the radiation beam. Because hepatocellular carcinoma often relapses, it is important to assess the anatomic site of liver dysfunction before and after radiation. This case demonstrates that 99m-technetium GSA SPECT is useful for this purpose

Scores of Child–Pugh Classification Impact Overall Survival After Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors

BackgroundStereotactic body radiotherapy (SBRT) delivers high-dose radiation to tumor tissues in few fractions, thereby reducing radiation damage to at-risk organs. There are more potential effects of SBRT owing to the higher biological equivalent dose delivered. Herein, we retrospectively analyzed its effectiveness and toxicity at our institution.MethodsData from patients with hepatocellular carcinoma (HCC; n = 10) and liver metastases (n = 10) who underwent SBRT (total dose of 30–50 Gy in 5–10 fractions) between 2013 and 2016 were analyzed. Adverse events were recorded at the end of RT, 6 months after treatment, or upon death. Overall survival (OS) was calculated according to the biological effective dose (BED α/β = 10) and liver function (Child–Pugh [CP] classification 5 or 6 vs. 7 or 8) after SBRT, using Kaplan–Meier analyses.ResultsOf the 20 patients, 6 declined the CP classification score after SBRT; grade 3 adverse events were not seen in any patient. A higher OS rate was seen in patients receiving a higher BED and in those with better CP classification after SBRT. Kaplan–Meier survival analysis yielded a median OS of 401 days and 1- and 2-year OS of 45% and 15%, respectively.ConclusionThe higher BED was significantly associated with tumor control, and there were no differences in the tumor control rate between HCC and metastatic tumors. Changes in CP scores after SBRT also affected the survival rate. Good liver function may permit multiple rounds of SBRT

Protective effect of alcohol consumption for fatty liver but not metabolic syndrome

AIM: To investigate the effect of alcohol on the metabolic syndrome (MS) and fatty liver in Japanese men and women

Aging is a risk factor of nonalcoholic fatty liver disease in premenopausal women

AIM: To clarify the relationship between age, menopause, and nonalcoholic fatty liver disease (NAFLD) in women

Data from: Association between serum γ-glutamyltranspeptidase and atherosclerosis: a population-based cross-sectional study

Objective: The purpose of this study was to determine the relationship between serum γ-glutamyltranspeptidase (GGT) and brachial-ankle pulse wave velocity (baPWV) as an indicator for atherosclerosis in Japanese men and women after adjusting for fatty liver. Design: A cross-sectional study. Setting: A health check-up centre in Japan. Participants: 912 Japanese men and women aged 24–84 years recruited from people who received a medical health check-up programme with a standardised questionnaire and an automatic waveform analyser to measure baPWV. Main outcome measures: We measured serum GGT concentrations and baPWV. Fatty liver was diagnosed by standardised criteria using abdominal ultrasonography. The postmenopausal state was defined as beginning 1 year after the cessation of menses. Results: In women, log2 GGT was positively associated with baPWV (β=0.11, 95% CI 0.02 to 0.19, p<0.05), independent of age, body mass index, systolic blood pressure, fasting plasma glucose, triglycerides, estimated glomerular filtration rate, fatty liver, menopausal state and parameters of lifestyles. However, in men, the positive association of log2 GGT with baPWV was not significant (β=−0.04, 95% CI −0.10 to 0.03, p=0.28) in multivariable linear regression analyses. Conclusions: The serum GGT level was associated with baPWV, independently of covariates including fatty liver or menopausal state just in women, but not in men

Identification of individuals with non-alcoholic fatty liver disease by the diagnostic criteria for the metabolic syndrome

AIM: To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease (NAFLD)

The positive association of serum gamma-glutamyltranspeptidase with atherosclerosis in females, not in males: a population based large scale cross-sectional study

Objective: The purpose of this study was to determine the relationship between serum gamma-glutamyltranspeptidase (GGT) and brachial-ankle pulse wave velocity (baPWV) as an indicator for atherosclerosis in Japanese males and females after adjusting fatty liver. Design: A cross-sectional study. Setting: A health checkup center in Japan. Participants: 846 Japanese males and females aged 24-84 years recruited from people who received a medical health checkup program with a standardized questionnaire and an automatic waveform analyzer to measure baPWV. Main outcome measures: We measured serum GGT concentrations and baPWV. Fatty liver was diagnosed by a standardized criteria using with abdominal ultrasonography. The postmenopausal state was defined as beginning 1 year after the cessation of menses. Results: In females, log2 GGT was positively associated with baPWV (β=0.11, 95% confidence interval (CI) 0.02-0.19, p<0.05) independent on age, BMI, systolic blood pressure, fasting plasma glucose, triglycerides, estimated glomerular ratio, fatty liver, menopausal state and parameters of life styles. However, in males, the positive association of log2 GGT with baPWV was not significant (β=-0.04, 95% CI -0.10-0.03, p=0.28) in multivariable linear regression analyses. Conclusions: The serum GGT level was associated with baPWV independently on co -variate including fatty liver or menopausal state just in females, but not in males. When the elevation of GGT was observed in females at clinical practice, we should check them using with some screening tests for atherosclerosis including baPWV