Preoperative measurement of segmental liver volume of donors for living related liver transplantation

Kawasaki, Seiji; Makuuchi, Masatoshi; Matsunami, Hidetoshi; Hashikura, Yasuhiko; Ikegami, Toshihiko; Chisuwa, Hisanao; Ikeno, Tatsuo; Noike, Terumasa; Takayama, Tadatoshi; Kawarazaki, Hideo

doi:10.1002/hep.1840180516

Cited by 206 publications

(136 citation statements)

References 16 publications

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“…After segmentation, the total liver surface was generated automatically and partitioned into its segments of individual portal venous supply with the segmental volumes being calculated automatically. In accordance with the literature [19], we found a large variance between the volumes of liver segments. In our study, volumes ranged from 760 to 1770 ml for the right lobe, 330 to 760 ml for the left lobe and 190 to 410 ml for the left lateral segments II+III.…”

Section: Graft Size and Volumetric Analysissupporting

confidence: 93%

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3D CT modeling of hepatic vessel architecture and volume calculation in living donated liver transplantation

et al. 2004

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The aim of this study was to evaluate a software tool for non-invasive preoperative volumetric assessment of potential donors in living donated liver transplantation (LDLT). Biphasic helical CT was performed in 56 potential donors. Data sets were post-processed using a non-commercial software tool for segmentation, volumetric analysis and visualisation of liver segments. Semi-automatic definition of liver margins allowed the segmentation of parenchyma. Hepatic vessels were delineated using a region-growing algorithm with automatically determined thresholds. Volumes and shapes of liver segments were calculated automatically based on individual portal-venous branches. Results were visualised three-dimensionally and statistically compared with conventional volumetry and the intraoperative findings in 27 transplanted cases. Image processing was easy to perform within 23 min. Of the 56 potential donors, 27 were excluded from LDLT because of inappropriate liver parenchyma or vascular architecture. Two recipients were not transplanted due to poor clinical conditions. In the 27 transplanted cases, preoperatively visualised vessels were confirmed, and only one undetected accessory hepatic vein was revealed. Calculated graft volumes were 1110 +/- 180 ml for right lobes, 820 ml for the left lobe and 270 +/- 30 ml for segments II+III. The calculated volumes and intraoperatively measured graft volumes correlated significantly. No significant differences between the presented automatic volumetry and the conventional volumetry were observed. A novel image processing technique was evaluated which allows a semi-automatic volume calculation and 3D visualisation of the different liver segments.

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Section: Graft Size and Volumetric Analysissupporting

confidence: 93%

“…Other studies reported in the current literature show acceptable correlations between estimated and measured liver volume as well [4,13,19,20]. Closer analysis of these studies showed differing deviations, such as systematic underestimation of left-lobe volume [19] and a high variance of the measurements [13,20].…”

Section: Graft Size and Volumetric Analysismentioning

confidence: 60%

3D CT modeling of hepatic vessel architecture and volume calculation in living donated liver transplantation

et al. 2004

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“…In these cases, accurate measurements of segmental liver volumes are important for both the donor and recipient. In a small study of living related donors, the volume of left lobe segments measured by CT correlated strongly with the actual volumes of the transplanted graft [4].…”

Section: Discussionmentioning

confidence: 96%

“…The liver is one organ where numerCorrespondence to: K. K. Kopecky ous attempts have been made to employ imaging techniques to make quantitative volumetric measurements. Measurements of liver volume have been used to make surgical decisions regarding hepatic resection or transplantation, to plan radiotherapy dosimetry, to assess the progress of various diseases, and to assess responses to treatment [1][2][3][4][5][6][7][8][9][10][11]. Most of the studies to date have been performed with conventional computed tomography (CT) after intravenous administration of iodinated contrast material, and some were performed after intra-arterial administration of iodinated contrast material (CT arterial portography).…”

mentioning

confidence: 99%

Measurement of liver volume using spiral CT and the curved line and cubic spline algorithms: reproducibility and interobserver variation

et al. 1999

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Background: The purpose of this article was to evaluate the accuracy and reproducibility of spiral computed tomography (CT) and the curved line and cubic spline algorithms in measuring liver volume. Methods: Spiral CT was performed in phantoms, cadaveric liver specimens, and 35 live human subjects (19 healthy volunteers and 16 patients). Images were transferred to a workstation, and volumes were measured by two observers. One observer repeated the measurements at a separate sitting. Results: The correlation between the CT measurement and the gold standard measurement of the cadaveric livers was very strong (r Å 0.94). For the live human subjects, the intraobserver and interobserver correlations were extremely high (r Å 0.999 and 0.997, respectively). The mean difference in liver volume measurements between the separate observations was 1%. Conclusion: The accuracy and reproducibility of this method of assessing liver volume are very high.

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“…In the first technique, the use of cross-imaging techniques can precisely determine the volume of liver tumors and liver mass [86]. The actual liver volume can be calculated with CT or MRI imaging techniques, on each slice both TLV and FRL are outlined, and the sum of the slices are calculated with integrated software [87]. Tumor volumes are considered nonfunctional liver parenchyma and subtracted from TLV [84,88].…”

Section: Limits For Safe Liver Resectionmentioning

confidence: 99%

How Much Remnant Is Enough in Liver Resection?

Guglielmi¹,

Ruzzenente²,

Conci³

et al. 2012

Dig Surg

293

204

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Background: Liver resection represents the first choice of treatment for primary and secondary liver malignancies, offering the patient the best chance of long-term survival. The extensive use of major hepatectomy increases the risk of post-hepatectomy liver failure (PHLF), which is associated with a high frequency of postoperative complications, mortality and increased length of hospital stay. Aims: The aim of this review is to investigate the different risk factors related to the occurrence of PHLF and to identify the limits for a safe liver resection in patients with normal liver and injured liver (cirrhosis, cholestasis, steatosis and post-chemotherapy liver injury). Methods: A literature search was undertaken in PubMed and related search engines, looking for articles relating to hepatic failure following hepatectomy in normal liver or injured liver. Results: In spite of improvements in surgical and postoperative management, the parameters determining how much liver can be resected are still largely undefined. A number of preoperative, intraoperative and postoperative factors all contribute to the likelihood of liver failure after surgery. The safe limits for liver resection can be estimated from the data of the literature for patients with normal liver and for those with different types of liver injury. Conclusions: Preoperative assessment that includes evaluation of liver volume and function of the remnant liver is a mandatory prerequisite before major hepatectomy. The critical residual liver volume for patients able to predict PHLF is mainly related to the presence of pre-existing liver disease and liver function. Among patients with normal liver, the limit for safe resection ranges from 20 to 30% future remnant liver of total liver volume. In patients with injured liver (cirrhosis, cholestasis or steatosis), preoperative assessment of the risk of PHLF should include future remnant liver volumetry and accurate liver function evaluation, including different dynamic liver function tests.

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Preoperative measurement of segmental liver volume of donors for living related liver transplantation

Cited by 206 publications

References 16 publications

3D CT modeling of hepatic vessel architecture and volume calculation in living donated liver transplantation

3D CT modeling of hepatic vessel architecture and volume calculation in living donated liver transplantation

Measurement of liver volume using spiral CT and the curved line and cubic spline algorithms: reproducibility and interobserver variation

How Much Remnant Is Enough in Liver Resection?

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