CT volumetry of the liver: Where does it stand in clinical practice?

Lim, Min-Cheol; Tan, Carolyn; Cai, Jianfei; Zheng, Jianmin; Kow, Alfred Wei Chieh

doi:10.1016/j.crad.2013.12.021

Cited by 106 publications

(89 citation statements)

References 53 publications

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“…More recently, with the advancement of three-dimensional imaging technologies, the importance of preoperative volumetric analysis for major hepatic resection has been increasingly emphasized (5,22). Previous studies have demonstrated that a small FLR is associated with worse postoperative hepatic function (23,24).…”

Section: Discussionmentioning

confidence: 99%

“…To overcome the possible limitations of Child-Pugh classification for predicting postoperative outcomes, liver computed tomography (CT) volumetry has been used to assist in the assessment of hepatic functional reserve in recent years, particularly when selecting HCC patients for major hepatic resection (5). Future liver remnant (FLR) volume measured preoperatively by three-dimensional CT reconstruction can accurately reflect the size of the remnant liver (6,7).…”

Section: Introductionmentioning

confidence: 99%

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Integration of Child-Pugh score with future liver remnant yields improved prediction of liver dysfunction risk for HBV-related hepatocellular carcinoma following hepatic resection

2017

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Abstract. Assessment of hepatic functional reserve is important to enable the selection of appropriate treatment methods and safe hepatic resection in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). In the present study, an evaluation was made of the clinical value of combining the Child-Pugh score (CPS) with the standardized future liver remnant (sFLR) measurement to predict postoperative liver dysfunction (PLD). A total of 61 HBV-related HCC patients undergoing liver volumetry prior to hepatectomy were enrolled in the study. The sFLR was calculated as the ratio of FLR volume to standardized liver volume. PLD was defined as a prothrombin time of >18 sec or a peak serum bilirubin level of >51.3 µmol/l for 7 days after surgery. Univariate analysis and multivariate logistic regression analysis were performed to identify risk factors associated with PLD. The correlation between PLD and the combination of sFLR and CPS was analyzed. In total, 18 out of 61 patients developed PLD (29.5%), with a significantly higher PLD incidence for a CPS of 6 than a CPS of 5 (P<0.05). Multivariate logistic regression analysis revealed that a prothrombin time of <13.3 sec and an sFLR of <0.55 were independent risk factors for PLD. Receiver operating characteristic (ROC) curve analysis revealed that the cut-off values of sFLR and sFLR/CPS for predicting PLD were 54.5% and 0.0916, respectively, with areas under the ROC curve of 0.820 and 0.860, respectively. The combination of CPS and sFLR appears to yield improved prediction of the occurrence of PLD compared with either CPS or sFLR alone.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Integration of Child-Pugh score with future liver remnant yields improved prediction of liver dysfunction risk for HBV-related hepatocellular carcinoma following hepatic resection

2017

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“…CT volumetry is now widely used for the preoperative volumetric assessment of the liver[10]. Traditionally, CT volumetry is performed by manually tracing the liver and by the summation of the liver volume in axial sections.…”

Section: Discussionmentioning

confidence: 99%

“…The morphological change of the liver as the fibrosis stage advances in other liver diseases such as chronic viral hepatitis, alcoholic hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis has been well documented[9], but the morphologic change of the liver caused by NAFLD is still unclear. Multidetector CT (MDCT) has been demonstrated to measure liver volume correctly, and CT volumetry has been used widely- especially as a method for preoperatively assessing the volume of the liver[10]. It would be clinically useful to be able to use CT volumetry to elucidate this morphological change and to predict the fibrosis stage in NAFLD noninvasively.…”

Section: Introductionmentioning

confidence: 99%

Fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment using computed tomography volumetry

Fujita

Nishie

Asayama

et al. 2016

WJG

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AIMTo evaluate the diagnostic performance of computed tomography (CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD).METHODSA total of 38 NAFLD patients were enrolled. On the basis of CT imaging, the volumes of total, left lateral segment (LLS), left medial segment, caudate lobe, and right lobe (RL) of the liver were calculated with a dedicated liver application. The relationship between the volume percentage of each area and fibrosis stage was analyzed using Spearman’s rank correlation coefficient. A receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of CT volumetry for discriminating fibrosis stage.RESULTSThe volume percentages of the caudate lobe and the LLS significantly increased with the fibrosis stage (r = 0.815, P < 0.001; and r = 0.465, P = 0.003, respectively). Contrarily, the volume percentage of the RL significantly decreased with fibrosis stage (r = -0.563, P < 0.001). The volume percentage of the caudate lobe had the best diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating fibrosis stage were as follows: ≥ F1, 0.896; ≥ F2, 0.929; ≥ F3, 0.955; and ≥ F4, 0.923. The best cut-off for advanced fibrosis (F3-F4) was 4.789%, 85.7% sensitivity and 94.1% specificity.CONCLUSIONThe volume percentage of the caudate lobe calculated by CT volumetry is a useful diagnostic parameter for staging fibrosis in NAFLD patients.

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“…At present, CTV is still the preferred imaging technique for liver volumetry. CTV of the liver is important in the preoperative planning for major hepatic resection and in the determination of the future remnant liver volume [25]. To increase the size of the liver remnant that will remain after surgery, the portal vein embolization (PVE) technique is used.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Surgical treatment of liver tumors – own experience and literature review

Tarasik¹,

Jaroszewicz

Januszkiewicz³

2017

ceh

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Despite advances, the treatment of focal liver lesions is still challenging. It requires the experience of a surgeon, improvement of existing and the development of new techniques. The aim of this article is to present a literature review and summarize our experience in liver surgery. Twenty-one patients with various liver tumors were treated in 2015 at the Department of Surgical Oncology of Bialystok Center for Oncology. Mostly patients were diagnosed with colorectal cancer liver metastases or hepatocellular carcinoma. Nine anatomical, 6 non-anatomical resections and 6 radiofrequency ablations were performed. Among 9 resections, 6 bisegmentectomies, resection of the 4b segment, and left-side and right-side hemihepatectomy were performed. Resections were associated only with minor postoperative complications. No perioperative mortality was noted. Preliminary outcomes of resections and radiofrequency ablations of liver lesions even in a low volume surgical center are promising and are associated with a relatively low rate of complications.

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CT volumetry of the liver: Where does it stand in clinical practice?

Cited by 106 publications

References 53 publications

Integration of Child-Pugh score with future liver remnant yields improved prediction of liver dysfunction risk for HBV-related hepatocellular carcinoma following hepatic resection

Integration of Child-Pugh score with future liver remnant yields improved prediction of liver dysfunction risk for HBV-related hepatocellular carcinoma following hepatic resection

Fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment using computed tomography volumetry

Surgical treatment of liver tumors – own experience and literature review

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