Evidence map›Paper›PMID 27349530›Full record

ArticleEJNMMI research2016

Measuring total liver function on sulfur colloid SPECT/CT for improved risk stratification and outcome prediction of hepatocellular carcinoma patients.

Stephen R Bowen, Tobias R Chapman, Joshua Borgman, Robert S Miyaoka, Paul E Kinahan, Iris W Liou, George A Sandison, Hubert J Vesselle, Matthew J Nyflot, Smith Apisarnthanarax

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EJNMMI research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.

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  15. Radiation-Induced Liver Disease and Modern Radiotherapy.Seminars in radiation oncology · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Stephen R BowenDepartment of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA. srbowen@uw.edu.
Tobias R ChapmanDepartment of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA.
Joshua BorgmanDepartment of Physics, University of Washington, 3910 15th Ave. NE, Seattle, WA, 98195, USA.
Robert S MiyaokaDepartment of Radiology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA.
Paul E KinahanDepartment of Radiology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA.
Iris W LiouDivision of Gastroenterology, Department of General Internal Medicine, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA, 98195, USA.
George A SandisonDepartment of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA.
Hubert J VesselleDepartment of Radiology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA.
Matthew J NyflotDepartment of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA.
Smith ApisarnthanaraxDepartment of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific St, Box 356043, Seattle, WA, 98195, USA.
University of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAssessment of liver function is critical in hepatocellular carcinoma (HCC) patient management. We evaluated parameters of [(99m)Tc] sulfur colloid (SC) SPECT/CT liver uptake for association with clinical measures of liver function and outcome in HCC patients.

methodsThirty patients with HCC and variable Child-Turcotte-Pugh scores (CTP A5-C10) underwent [(99m)Tc]SC SPECT/CT scans for radiotherapy planning. Gross tumor volume (GTV), anatomic liver volume (ALV), and spleen were contoured on CT. SC SPECT image parameters include threshold-based functional liver volumes (FLV) relative to ALV, mean liver-to-spleen uptake ratio (L/Smean), and total liver function (TLF) ratio derived from the product of FLV and L/Smean. Optimal SC uptake thresholds were determined by ROC analysis for maximizing CTP classification accuracy. Image metrics were tested for rank correlation to composite scores and clinical liver function parameters. Image parameters of liver function were tested for association to overall survival with Cox proportional hazard regression.

resultsOptimized thresholds on SC SPECT were 58 % of maximum uptake for FLV, 38 % for L/Smean, and 58 % for TLF. TLF produced the highest CTP classification accuracy (AUC = 0.93) at threshold of 0.35 (sensitivity = 0.88, specificity = 0.86). Higher TLF was associated with lower CTP score: TLFA = 0.6 (0.4-0.8) versus TLFB = 0.2 (0.1-0.3), p < 10(-4). TLF was rank correlated to albumin and bilirubin (|R| > 0.63). Only TLF >0.30 was independently associated with overall survival when adjusting for CTP class (HR = 0.12, 95 % CI = 0.02-0.58, p = 0.008).

conclusionsSC SPECT/CT liver uptake correlated with differential liver function. TLF was associated with improved overall survival and may aid in personalized oncologic management of HCC patients.

Indexed as

Child-PughHCCLiver functionROCSPECT/CTSulfur colloid

Identifiers

PMID27349530
PMCPMC4923007
OpenAlexW2471826209

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.