Use of multidetector row CT with volume renderings in right lobe living liver transplantation

Ishifuro, Minoru; Horiguchi, Jun; Nakashige, Aya; Tamura, Akira; Marukawa, Kazushi; Fukuda, Hiroshi; Ono, Chiaki; Akiyama, Yuji; Kushima, Toshio; Ito, Katsuhide

doi:10.1007/s00330-002-1431-1

Cited by 32 publications

(14 citation statements)

References 18 publications

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“…With MDCT, thin slices can be obtained with excellent temporal resolution and precise 3D models can be created. Recently, MDCT volumetry of the donor of partial liver grafts, with manual or automatic processing 3D techniques, proved to be accurate [21] and liver CT angiography has become a substitute for invasive angiography [22]. Moreover, the relationship of the vasculature with anatomical structures, like the gallbladder, can be clearly visualized by simultaneous display, like that proposed here.…”

Section: Discussionmentioning

confidence: 89%

Fusion of the midplane with the left intersectional plane: a liver anatomical variation revisited with multidetector-row CT

et al. 2006

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This article updates the description of an anatomical variation of the liver, in which the gallbladder is adjacent to the ligamentum teres, that was described until now as "right-sided ligamentum teres and right umbilical portion of the portal vein". A study of eight patients showing this anatomical variation has led to a new archetypal anatomical description of the hepatic and portal veins, using multidetector-row computed tomography (MDCT) with three-dimensional (3D) volume-rendering (VR) reconstructions. While 2D axial imaging gave the same information, MDCT imaging with VR reconstructions provided a clear 3D visualization of this anatomical variation. Typical features can be described as follows: (1) juxtaposition of the ligamentum teres and the gallbladder; (2) typical portal vein branching with a right posterior branch, a left posterior branch and a main medial branch that terminates in the ligamentum teres; (3) two main hepatic veins and a hypotrophied medial hepatic vein. We think, based on the direct comparison of anatomical findings and knowledge of chronological embryological development, that this abnormality results from the defective development of the central part of the liver and not from the persistence of the right rather than the left umbilical vein. Because of the presence of only one medial plane, containing both the gallbladder and the ligamentum teres, we propose renaming it "fusion of hepatic planes".

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Section: Discussionmentioning

confidence: 89%

Fusion of the midplane with the left intersectional plane: a liver anatomical variation revisited with multidetector-row CT

et al. 2006

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“…It has recently been shown that volumetric assessment of tumor burden gives different results for treatment response than long-axis or bi-dimensional measurements; thus, in the near future volumetric measurement techniques may be employed for accurate quantification of tumor burden (Saini [19], presented at the Radiological Society of North America, December 2001). Volume rendering with multidetector-row CT has also recently been utilized in planning partial liver transplantation [20].…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of linear tumor measurements using PACS: comparison of caliper method with edge-tracing method

et al. 2004

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The aim of this study was to evaluate inter-and intra-observer reproducibility when making electronic caliper linear tumor measurements on picture archiving and communications systems (PACS) and compare them with linear measurements obtained from circumferential tracing of tumor perimeter. Three radiologists measured 64 masses from 30 patients on body CT scans in two separate settings. Long axis and perpendicular short axis were measured using electronic calipers. The edge of each tumor was traced electronically and the long and short axes were calculated by computer software. The reproducibility of a measurement was evaluated by computing and comparing the absolute value of the mean difference between initial and subsequent measurements. The mean differences ±95% confidence interval (CI) between two measurements of the long by short axis were 3.8±2.6×3.1±1.8 mm when the caliper method was used and 3.5±2.0×3.2±1.5 mm when the tumor tracing method was used. There was no statistically significant difference in individual intra-observer reproducibility of tumor axes measurements. Neither long-nor short-axis single-dimension measurements resulted in significantly greater or lesser intra-observer reproducibility. When comparing caliper and tracing measurements, the overall mean difference (3.42±1.8 vs 3.38±1.4 mm) was not statistically significant. There was close correlation between the individual measurements made by each observer whether these were made by electronic calipers and when these were calculated from electronic tracings (Pearson correlations between 0.79 and 0.949). Current PACS systems allow reproducible linear, long or short axis, tumor measurements. There is no significant difference in reproducibility of measurements whether these are made directly with electronic calipers or calculated from tumor edge tracings.

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“…Since impaired liver function after resection and transplantation is caused by insufficient liver volume [1], a reliable volumetric assessment of the hepatic segments of potential living donors is one of the key factors in the preoperative donor evaluation. Recently, preoperative liver volumetry based on CT volume data sets resulted in significantly improved clinical outcome [2,3,4]; however, these procedures require an arbitrary definition of the potential resection line along the middle hepatic vein and are therefore relatively operator dependent. Although several refinements in semi-automatic liver volumetry have been introduced, leading to individualised computer-generated resection protocols [5], there is no report concerning automatic liver segmentation and volumetry on the basis of the intrahepatic portal venous blood supply.…”

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confidence: 99%

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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Use of multidetector row CT with volume renderings in right lobe living liver transplantation

Cited by 32 publications

References 18 publications

Fusion of the midplane with the left intersectional plane: a liver anatomical variation revisited with multidetector-row CT

Fusion of the midplane with the left intersectional plane: a liver anatomical variation revisited with multidetector-row CT

Reproducibility of linear tumor measurements using PACS: comparison of caliper method with edge-tracing method

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

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