Clinical application of TcGSA.

Asialoglycoprotein receptor (ASGP-R) is a hepatic cell surface receptor specific for galactose-terminated glycoprotein. The (99m)Tc-labeled asialoglycoprotein analog, TcGSA (galactosyl-human serum albumin-diethylenetriamine-pentaacetic acid) has been applied to human hepatic receptor imaging. This method is unique and provides information that is totally independent of the ICG test or Child-Turcotte Score. However, simple parameters, HH15 or LHL15 are no better than conventional Child-Turcotte Score. Parameters obtained from kinetic modeling were useful in detecting liver cirrhosis or postoperative liver failure. They provide quantitative data on functioning liver mass. Considering the moderate cost and widespread availability of gamma cameras, a TcGSA test should be performed on patients whose liver function are not adequately estimated by an ICG test or a Child-Turcotte score.