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Hepatic TumorsPhase 4NCT07358975

Prediction of Complications in Hepatic Tumors

A Phase 4 study testing [99mTc] Tc-GSA SPECT/CT in people with Hepatic Tumors, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Liver failure is one of the most severe complications in patients undergoing liver surgery for hepatic malignancies. However, it can be predicted through preoperative assessment of liver function. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
Hepatic Tumors
What is being tested?
[99mTc] Tc-GSA SPECT/CT
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
192 participants
Where
1 siteDenmark
Study dates
Mar 2026to Dec 2028
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults over 18 years who have the capacity to act, with a confirmed or suspected diagnosis of one or more hepatic tumors and a planned local treatment proposed by a multidisciplinary team of specialists, specifically those:
  • Patients undergoing major liver resection (FLR < 40%).
  • Patients undergoing minor resections or open/laparoscopic ablations with a risk of impaired liver function, defined by at least one of the following:
  • Histological diagnosis of liver cirrhosis or fibrosis (Meta-analysis of Histological Data in Viral Hepatitis scoring system [METAVIR] score 1 to 4).
  • Radiological signs of cirrhosis.
  • Preoperative chemotherapy.
  • Known liver disease associated with cirrhosis: metabolic dysfunction-associated steatohepatitis, chronic infection with hepatitis B or C, primary sclerosing cholangitis, primary biliary cholangitis, and autoimmune hepatitis.

Who cannot join

  • History of hypersensitivity to Technetium-99m or albumin
  • Diagnosis of pulmonary hypertension,
  • Pregnant or breastfeeding individuals. For fertile women, non-pregnancy must be confirmed by a negative pregnancy test. No contraception methods are required after the study due to the short radioactive half-life of the IMP.
  • Patients under 18 years old or unable to make autonomous care decisions.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Denmark1 site
  • Rigshospitalet

    Copenhagen, 2100

    Hans-Christian Pommergaard, +45 23 24 18 21, hans-christian.pommergaard@regionh.dk

    hans-christian.pommergaard@regionh.dk

Other trials in Denmark

About this study

Official title: Prediction of Complications in Patients Undergoing Surgical Treatment of Hepatic Tumors

Liver failure is one of the most severe complications in patients undergoing liver surgery for hepatic malignancies. However, it can be predicted through preoperative assessment of liver function. Technetium-99m galactosyl human serum albumin ([99mTc] Tc-GSA), combined with single-photon emission computed tomography fused with computed tomography ([99mTc] Tc-GSA SPECT/CT), is widely used in Asia due to its superiority in predicting postoperative liver failure. Unfortunately, its clinical use in Western countries remains limited due to concerns about disease transmission.

In 2022, the Department of Clinical Physiology and Nuclear Medicine at Rigshospitalet optimized the in-house production of [99mTc] Tc-GSA under European regulations, and in April 2025, received approval from the Danish Medicines Agency for its clinical use. This study aims to evaluate, for the first time, the diagnostic accuracy of [99mTc] Tc-GSA SPECT/CT in quantifying liver function in European patients with hepatic tumors.

Read more

Hypothesis: [99mTc] Tc-GSA SPECT/CT is capable of and superior to indocyanine green clearance test (ICG), Child-Pug score, Model for End-Stage Liver Disease (MELD) score, and ultrasound elastography in quantifying liver function and predicting surgical outcomes in a Danish cohort of patients with liver tumors. Perceived quality of life may be associated with postoperative complications. However, postoperative complications and survival can be more accurately predicted when quality of life is assessed in combination with preoperative liver function and clinical conditions.

Objectives

Primary objectives:

  1. To evaluate the correlation between [99mTc] Tc-GSA SPECT/CT and established liver function assessments, including ICG clearance, Child-Pugh score, MELD score, and ultrasound elastography.
  2. To compare the discriminative ability of [99mTc] Tc-GSA SPECT/CT with existing liver function tests in predicting postoperative complications. Secondary objectives:
  3. To assess the correlation of [99mTc] Tc-GSA SPECT/CT, ICG clearance, Child-Pugh score, MELD score, and ultrasound elastography with postoperative outcomes.
  4. To develop and internally validate a multivariable predictive model combining the best predictive liver function test with preoperative clinical characteristics to predict postoperative complications.
Conditions
Hepatic Tumors
Being tested
[99mTc] Tc-GSA SPECT/CT
Medical subject headings
Carcinoma, Hepatocellular

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • [99mTc] Tc-GSA SPECT/CTDiagnostic test

    To evaluate preoperative liver function using [99mTc] Tc-GSA SPECT/CT, participants will receive an intravenous injection of 185 MBq/3 mg [99mTc] Tc-GSA through a peripheral vein. SPECT imaging will be performed 20 minutes after tracer injection.

Study groups in NCT07358975
Study groupRoleWhat they receive
All participantsExperimentalNot described
Receives: Diagnostic Test: [99mTc] Tc-GSA SPECT/CT

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Correlation between [99mTc] Tc-GSA SPECT/CT parameters and ICG clearance

    The correlation between quantitative liver uptake parameters derived from [99mTc] Tc-GSA SPECT/CT and indocyanine green (ICG) clearance will be assessed using Pearson's/Spearman's rank correlation coefficient.

    [99mTc] Tc-GSA SPECT/CT units: Liver function test expresed in Uptake Index (UI) and percentage of total liver volume (FLR%).

    Indocyanine green (ICG) clearance units: Liver function test reported as: 1.- ICG retention ratio after 15 min (ICGR15), unit: percentage (%) 2.- Rate constant (k) of ICG indicator-dilution curve (KICG), unit: min-1 3.- Plasma dis-appearance rate of ICG (PDRICG), unit: % min-1.

    Measured: Once before receiving the planned treatment for a hepatic tumor.

  2. Correlation between [99mTc] Tc-GSA SPECT/CT parameters and Child-Pugh score

    The correlation between quantitative [99mTc] Tc-GSA SPECT/CT-derived liver function parameters and Child-Pugh score will be assessed using Pearson's/Spearman's rank correlation coefficient.

    [99mTc] Tc-GSA SPECT/CT units: Uptake Index (UI) and percentage of total liver volume (FLR%).

    Child-Pug score description and units: : Scoring system that estimates cirrhosis severity. It classifies patients into three categories: A - good hepatic function, B - moderately impaired hepatic function, and C - advanced hepatic dysfunction.

    Measured: Once before receiving the planned treatment for a hepatic tumor.

  3. Correlation between [99mTc] Tc-GSA SPECT/CT parameters and the Model for End-Stage Liver Disease (MELD) score

    he correlation between quantitative [99mTc] Tc-GSA SPECT/CT-derived liver function parameters and MELD score will be assessed using Pearson's/Spearman's rank correlation coefficient.

    [99mTc] Tc-GSA SPECT/CT units: Uptake Index (UI) and percentage of total liver volume (FLR%).

    MELD score definition and units: The Model for End-Stage Liver Disease (MELD) is a prognostic score to measure the severity of liver failure. The MELD score is based on results from five blood tests: Bilirubin, Creatinine, Internal normalized ratio (INR), Serum sodium, and Albumin. The MELD score ranges from 6 to 40, and quantifies end-stage liver disease for transplant planning. The higher the score, the more severe the disease.

    Measured: Once before receiving the planned treatment for a hepatic tumor.

  4. Correlation between [99mTc] Tc-GSA SPECT/CT parameters and liver stiffness measured by ultrasound elastography

    The correlation between quantitative [99mTc] Tc-GSA SPECT/CT-derived liver function parameters and liver stiffness measured by ultrasound elastography will be assessed using Pearson's/Spearman's rank correlation coefficient.

    99mTc] Tc-GSA SPECT/CT units: Uptake Index (UI) and percentage of total liver volume (FLR%) Ultrasound elastography: kilopascals (kPa)

    Measured: Once before receiving the planned treatment for a hepatic tumor.

  5. Discriminative ability of [99mTc] Tc-GSA SPECT/CT compared with standard liver function tests to predict major postoperative complications

    The discriminative ability of [99mTc]Tc-GSA SPECT/CT to predict major postoperative complications (Clavien-Dindo grade ≥ III) will be compared with standard liver function tests, including ICG clearance, Child-Pugh score, MELD score, and ultrasound elastography (units and definitions have been previously described).

    The Clavien-Dindo classification ranks the severity of surgical complications and consists of seven grades (I, II, IIIa, IIIb, IVa, IVb, and V). Complications of grade ≥ III will be considered major.

    Discriminative performance will be assessed using the area under the receiver operating characteristic curve (AUC) for each test. AUCs will be compared using DeLong's test.

    Measured: Once after the completion of 90-day follow-up.

Secondary outcomes (5)
  1. Association of [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography with 90-day mortality

    A regression model will be run between the variables. Parameters derived from [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography will be treated as independent variables, while 90-day mortality will be treated as binary and dependent variable.

    Units for [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography has been described before.

    90-day mortality categories: yes, no.

    Measured: Once during the final analysis after completion of 90-day follow-up.

  2. Association of [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography with post-hepatectomy liver failure

    A regression model will be run between the variables. Parameters derived from [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography will be treated as independent variables, while post-hepatectomy liver failure will be treated as binary and dependent variable.

    Units for [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography has been described before.

    Post-hepatectomy liver failure categories: yes, no

    Measured: Once during the final analysis after completion of 90-day follow-up.

  3. Association of [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography with length of stay.

    A regression model will be run between the variables. Parameters derived from [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography will be treated as independent variables, while length of stay. will be treated as dependent variable.

    Units for [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography has been described before.

    Units for length of stay: days

    Measured: Once during the final analysis after completion of 90-day follow-up.

  4. Association of [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography with readmission.

    A regression model will be run between the variables. Parameters derived from [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography will be treated as independent variables, while readmision will be treated as binary and dependent variable.

    Units for [99mTc] Tc-GSA, ICG, Child-Pugh, MELD, and ultrasound elastography has been described before.

    Readmision: yes, no

    Measured: Once during the final analysis after completion of 90-day follow-up.

  5. Model development and internal validation of a multivariable predictive model combining the most accurate liver function test with preoperative clinical factors (frailty, sarcopenia, grip strength, age, sex, etc.) to predict complications.

    The model performance will be assessed using penalized regression with discrimination, calibration, and bootstrap validation.

    Measured: Once during the final analysis after completion of 90-day follow-up.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Jan 2026
  2. Study startMar 2026 (estimated)
  3. Primary completionJul 2028 (estimated)
  4. Study completionDec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Model description
The aim of this study is to evaluate the diagnostic accuracy of \[99mTc\] Tc-GSA SPECT/CT in quantifying liver function in European patients with hepatic tumors. For accomplish this objective, in 2022, the Department of Clinical Physiology and Nuclear Medicine at Rigshospitalet optimized the in-house production of \[99mTc\] Tc-GSA under European regulations, and in April 2025, received approval from the Danish Medicines Agency for its clinical use. The compassionate permit allows the use of \[99mTc\] Tc-GSA for preoperative evaluation of regional liver function in the part of the liver that is preserved after liver resection due to malignant liver disease (primary liver cancer, primary biliary cancer and colorectal liver metastases). This study will explore the benefits of using \[99mTc\] Tc-GSA in combination with SPECT/CT in patients with a confirmed or suspected diagnosis of hepatic tumor (benign ot malignant) and a planned local treatment (resection and/or ablation).
Masking
None (open label)
Enrolment
192 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07358975
Sponsor's protocol ID
GSA-HEPSURU-RH
Status last verified
Nov 2025
First submitted
5 Dec 2025
Last updated
22 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing [99mTc] Tc-GSA SPECT/CT in people with Hepatic Tumors, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 22 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hans-Christian Pommergaard (+45 23 24 18 21, hans-christian.pommergaard@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Correlation between [99mTc] Tc-GSA SPECT/CT parameters and ICG clearance (time frame: Once before receiving the planned treatment for a hepatic tumor.). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2026.

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