Purpose: The aim of this joint EANM/SNMMI/IHPBA procedure guideline is to provide general infor-mation and specific recommendations and considerations on the use of [99mTc]Tc-mebrofenin hepato... Show morePurpose: The aim of this joint EANM/SNMMI/IHPBA procedure guideline is to provide general infor-mation and specific recommendations and considerations on the use of [99mTc]Tc-mebrofenin hepato-biliary scintigraphy (HBS) in the quantitative assessment and risk analysis before surgical intervention, selective internal radiation therapy (SIRT) or before and after liver regenerative procedures. Although the gold standard to estimate future liver remnant (FLR) function remains volumetry, the increasing interest in HBS and the continuous request for implementation in major liver centers worldwide, demands standardization.Methods: This guideline concentrates on the endorsement of a standardized protocol for HBS elabo-rates on the clinical indications and implications, considerations, clinical appliance, cut-off values, in-teractions, acquisition, post-processing analysis and interpretation. Referral to the practical guidelines for additional post-processing manual instructions is provided.Conclusion: The increasing interest of major liver centers worldwide in HBS requires guidance for implementation. Standardization facilitates applicability of HBS and promotes global implementation. Inclusion of HBS in standard care is not meant as substitute for volumetry, but rather to complement risk evaluation by identifying suspected and unsuspected high-risk patients prone to develop post-hepatectomy liver failure (PHLF) and post-SIRT liver failure. Show less
