Accurate preoperative estimation of liver-graft volumetry using three-dimensional computed tomography

Hiroshige, Shoji; Shimada, Mitsuo; Harada, Noboru; Shiotani, Satoko; Ninomiya, Mizuki; Minagawa, Ryousuke; Soejima, Yuji; Suehiro, Taketoshi; Honda, Hiroshi; Hashizume, Makoto; Sugimachi, Keizō

doi:10.1097/01.tp.0000053755.08825.12

Cited by 123 publications

(136 citation statements)

References 11 publications

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“…The remnant liver must therefore be able to overcome the necrosis, preserving or recovering an adequate synthetic ability [22] ; as a consequence, there must be an adequate and functional FLRV to avoid PHLF [23] . Despite this, there is no uniform consensus among hepatic surgeons on the amount of liver volume that can be safely resected, with a wide range of reported values [24,25] . Guglielmi et al [24] reported that in patients with "healthy" liver (absence of hepatic diffuse disease, normal functionality tests) the limit of FLRV% for a safe resection varies between 20% and 30%, while in patients with underlying hepatic disease (cirrhosis, cholestasis, steatosis) the critical FLRV% value rise up to 30%-40%.…”

Section: Introductionmentioning

confidence: 99%

Liver volumetry: Is imaging reliable? Personal experience and review of the literature

D’Onofrio

Robertis

Demozzi

et al. 2014

WJR

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The amount of the future liver remnant volume is fundamental for hepato-biliary surgery, representing an important potential risk-factor for the development of post-hepatectomy liver failure. Despite this, there is no uniform consensus about the amount of hepatic parenchyma that can be safely resected, nor about the modality that should be chosen for this evaluation. The pre-operative evaluation of hepatic volume, along with a precise identification of vascular and biliar anatomy and variants, are therefore necessary to reduce surgical complications, especially for extensive resections. Some studies have tried to validate imaging methods [ultrasound, computed tomography (CT), magnetic resonance imaging] for the assessment of liver volume, but there is no clear evidence about the most accurate method for this evaluation. Furthermore, this volumetric evaluation seems to have a certain degree of error, tending to overestimate the actual hepatic volume, therefore some conversion factors, which should give a more reliable evaluation of liver volume, have been proposed. It is widespread among non-radiologists the use of independent software for an off-site volumetric analysis, performed on digital imaging and communications in medicine images with their own personal computer, but very few studies have provided a validation of these methods. Moreover, while the pre-transplantation volumetric assessment is fundamental, it remains unclear whether it should be routinely performed in all patients undergoing liver resection. In this editorial the role of imaging in the estimation of liver volume is discussed, providing a review of the most recent literature and a brief personal series of correlations between liver volumes and resection specimens' weight, in order to assess the precision of the volumetric CT evaluation.

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Section: Introductionmentioning

confidence: 99%

Liver volumetry: Is imaging reliable? Personal experience and review of the literature

D’Onofrio

Robertis

Demozzi

et al. 2014

WJR

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“…Among the suggested causes of errors in estimating liver volume by volumetric CT are partial volume effects, examination technique, hepatic physical density, exact contour and segment recognition, intraoperative drainage of liquid from the liver, and hepatic volume variation. 7,9,10,30 It is likely that blood volume contributes a significant portion of the error because this volume is included in CT volumetry, whereas graft weight is generally measured in a blood-free manner. 31 In the present study, however, we used a blood-free CT technique for all subjects to minimize the effects of blood volume and maximize those of hepatic steatosis.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11] In addition, CT volume measurements have been shown to be well-correlated with the values calculated by various numerical formulas for liver weight/volume combining parameters, such as body weight, height, and body surface area. 7,8,11 Thus, CT volumetry is widely used for estimating liver volume. 12 Because human fat has a density of 0.9 g/cm³ and contains less functional mass (g) than normal liver per unit volume (cm³), there is a possibility of error in estimating liver mass by CT volumetry in patients with hepatic steatosis, especially in severe cases.…”

Section: Introductionmentioning

confidence: 96%

“…Graft mass esti mation error (%) was calculated from the following numerical formula: [(liver volume determined by preoperative CT volumetry (mL) minus intraoperative actual graft mass) / intraoperative actual graft mass] × 100, with 1 cm³ of liver graft considered to weigh 1 g. 7,15 The chi-square test was used to compare baseline categorical variables, and the Kruskal-Wallis test was used to compare continuous variables across the 4 groups. The calculated graft mass estimation errors (%) were compared across the groups by the KruskalWallis test.…”

Section: Statistical Analysesmentioning

confidence: 99%

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Shim²,

Song³

et al. 2017

Exp Clin Transplant

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Objectives: Our objective was to assess the accuracy of computed tomography volumetry in estimating liver volume in steatotic patients. Materials and Methods: We divided 641 liver donors (mean age 27 years, 71% male) into 4 groups ac cording to the extent of steatosis on predonation biopsy: with < 5% comprising group 1, 5% to 9% comprising group 2, 10% to 19% comprising group 3, and ≥ 20% comprising group 4. Graft mass estimation error (%) was calculated as follows: [(computed tomographymeasured volume minus graft weight)/graft weight] × 100. We obtained estimation errors, intraclass correlation coefficients, and Pearson correlation coefficients across the groups. Results: Baseline alanine aminotransferase and gammaglutamyltranspeptidase values were signi ficantly correlated with extent of steatosis. Mean graft weight and computed tomography-measured volume were 725.9 g and 741.2 mL. Mean estimation errors were comparable (1.5% for group 1, 2.7% for group 2, 3.0% for group 3, and 3.9% for group 4; P = .77). In multivariate linear regression, estimation error was inversely correlated with high-density lipoprotein cholesterol (P = .008). Overall, there was an excellent agreement between measured volume and actual weight, with intraclass correlation coefficients over 0.85 and Pearson correlation coefficients over 0.70 in all groups (P < .001).Conclusions: Preoperative computed tomography volumetry is an accurate tool for estimating volume regardless of the extent of steatosis.

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“…According to preceding research, Hiroshige et al, reported that it is important to understand the anatomical structure of blood vessels in the liver and bile duct in the donors and recipients accurately before transplantation through imaging screening for the donors' safety and the prevention of liver dysfunction after the transplantation [11]. MRCP technology has improved since it was first known by Dooms et al In 1986, and currently, MRCP is used to provide quality diagnostic images for the pancreaticobiliary duct by imaging the bile in the pancreaticobiliary duct with high signal intensity.…”

Section: Discussionmentioning

confidence: 99%

A Study on Parallel Imaging for the Improvement of Sharpness in MRCP for Liver Transplantation

Goo

2015

IJBSBT

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Accurate preoperative estimation of liver-graft volumetry using three-dimensional computed tomography

Abstract: Three-dimensional CT volumetry is useful for size matching in cases of living-related orthotopic liver transplantation.

Cited by 123 publications

References 11 publications

Liver volumetry: Is imaging reliable? Personal experience and review of the literature

Liver volumetry: Is imaging reliable? Personal experience and review of the literature

Untitled

A Study on Parallel Imaging for the Improvement of Sharpness in MRCP for Liver Transplantation

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