The Correlation between the CT Liver Volume and the Actual Weight of the Resected Cirrhotic Liver in Transplantation Patients

Authors

  • Kulyada Eurboonyanun Department of Radiology, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002, Thailand.
  • Chalerm Eurboonyanun Department of Surgery, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002, Thailand.
  • Julaluck Promsorn Department of Radiology, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002, Thailand.
  • Jiranthanin Phaorod Department of Radiology, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002, Thailand.
  • Tharatip Srisuk Department of Surgery, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002, Thailand.
  • Nittaya Chamadol Department of Radiology, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002, Thailand.
  • Mukesh Harisinghani Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, United States of America.

DOI:

https://doi.org/10.31584/jhsmr.2021855

Keywords:

computed tomography volumetry, hepatic resection, liver surgery, liver transplantation, liver volume

Abstract

Objective: Volumetric assessment with computed tomography (CT), known as CT volumetry, is the preferred method for estimating future liver remnant. However, the data regarding the usage of CT volumetry to estimate future liver remnant of the diseased liver is still lacking. This study was designed to evaluate the correlation between the liver volume, calculated by CT, and the actual weight of the resected liver in patients who underwent orthotopic liver transplantation.

Material and Methods: A total of 32 patients having underwent liver transplantation; from March 2009 to June 2015, were included. A radiologist retrospectively reviewed the pre-operative CT and performed the volume measurement. Statistical analysis was performed to determine the relationship between the estimated liver volume and the actual liver weight.

Results: The estimated liver volume was significantly different among the cirrhosis of different etiology (p-value=0.001 for the total liver volume and p-value=0.003 for the functional liver volume). Compared with the total liver volume, the functional liver volume had a stronger correlation with the actual weight of the resected liver (r=0.955 vs. r=0.786). The following formula can be used to accurately estimate the expected weight of the resected liver (expected liver weight: ELW), based on the estimated functional liver volume (FLV) derived by CT volumetry: ELW=489.531+(0.618*FLV). The R-squared for this regression model was 0.914.

Conclusion: CT volumetry is reliable and accurate in predicting the actual amount of the resected liver parenchyma in cirrhotic patients.

References

Chedid MF, Kruel CRP, Pinto MA, Grezzana-Filho TJM, Leipnitz I, Kruel CDP, et al. Hepatocellular carcinoma: diagnosis and operative management. Arq Bras Cir Dig 2017;30:272–8.

Cillo U, Fondevila C, Donadon M, Gringeri E, Mocchegiani F, Schlitt HJ, et al. Surgery for cholangiocarcinoma. Liver Int 2019; 39(Suppl 1):143–55.

Hadden WJ, de Reuver PR, Brown K, Mittal A, Samra JS, Hugh TJ. Resection of colorectal liver metastases and extrahepatic disease: a systematic review and proportional meta-analysis of survival outcomes. HPB 2016;18:209–20.

Bacalbașa N, Balescu I, Dima S, Popescu I. Long-term survivors after liver resection for breast cancer liver metastases. Anticancer Res 2015;35:6913–7.

Grimme FAB, Seesing MFJ, van Hillegersberg R, van Coevorden F, de Jong KP, Nagtegaal ID, et al. Liver resection for hepatic metastases from soft tissue sarcoma: a nationwide study. DSU 2019;36:479–86.

Clarke NAR, Kanhere HA, Trochsler MI, Maddern GJ. Liver resection for non-colorectal non-neuroendocrine metastases. ANZ J Surg 2018;88:E313–7.

Gandy RC, Bergamin PA, Haghighi KS. Hepatic resection of non-colorectal non-endocrine liver metastases. ANZ J Surg 2017;87:810–4.

Ray S, Mehta NN, Golhar A, Nundy S. Post hepatectomy liver failure – A comprehensive review of current concepts and controversies. Ann Med Surg (Lond) 2018;34:4–10.

Rahnemai-Azar AA, Cloyd JM, Weber SM, Dillhoff M, Schmidt C, Winslow ER, et al. Update on liver failure following hepatic resection: strategies for prediction and avoidance of postoperative liver insufficiency. J Clin Transl Hepatol 2018;6:97– 104.

Schindl MJ, Redhead DN, Fearon KCH, Garden OJ, Wigmore SJ. The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut 2005;54:289–96.

Ribero D, Zimmitti G, Aloia TA, Shindoh J, Forchino F, Amisano M, et al. Preoperative cholangitis and future liver remnant volume determine the risk of liver failure in patients undergoing Resection for Hilar Cholangiocarcinoma. J American Coll Surg 2016;223:87–97.

Alizai PH, Haelsig A, Bruners P, Ulmer F, Klink CD, Dejong CHC, et al. Impact of liver volume and liver function on posthepatectomy liver failure after portal vein embolization– A multivariable cohort analysis. Annal Med Surg 2018;25:6–11.

Lim MC, Tan CH, Cai J, Zheng J, Kow AWC. CT volumetry of the liver: Where does it stand in clinical practice?. Clin Radiol 2014;69:887–95.

Khan AS, Garcia-Aroz S, Ansari MA, Atiq SM, Senter-Zapata M, Fowler K, et al. Assessment and optimization of liver volume before major hepatic resection: current guidelines and a narrative review. Int J Surg 2018;52:74–81.

Karlo C, Reiner CS, Stolzmann P, Breitenstein S, Marincek B, Weishaupt D, et al. CT- and MRI-based volumetry of resected liver specimen: Comparison to intraoperative volume and weight measurements and calculation of conversion factors. European J Radiol 2010;75:e107–11.

Sa L, Gk B. Standard formulae in predicting liver volumes: a South East Asian Series of Adult Living Donors. J Transplant Technol Res 2016:6:1.

Pomposelli JJ, Tongyoo A, Wald C, Pomfret EA. Variability of standard liver volume estimation versus software-assisted total liver volume measurement. Liver Transplant 2012;18:1083–92.

Goumard C, Perdigao F, Cazejust J, Zalinski S, Soubrane O, Scatton O. Is computed tomography volumetric assessment of the liver reliable in patients with cirrhosis?. HPB (Oxford) 2014;16:188–94.

Zakareya T, Abbasy M, Abdel-Razek W, Abdelkader Salama I, Deif M. A novel formula for graft weight estimation from preoperative computed tomography volumetric measurement in living donor liver transplantation. Transplant Technol 2017;5:1.

Pinheiro RS, Cruz-Jr RJ, Andraus W, Ducatti L, Martino RB, Nacif LS, et al. Preoperative computed tomography volumetry and graft weight estimation in adult living donor liver transplantation. Abcd Arq Bras Cir Dig 2017;30:38–41.

Sonnemans L, Hol J, Monshouwer R, Prokop M, Klein W. Correlation between liver volumetric computed tomography results and measured liver weight: a tool for preoperative planning of Liver Transplant. Exp Clin Transplant 2016;14: 72-822.

Lemke A-J, Brinkmann MJ, Schott T, Niehues SM, Settmacher U, Neuhaus P, et al. Living donor right liver lobes: preoperative CT volumetric measurement for calculation of intraoperative weight and volume. Radiol 2006;240:736–42.

Golse N. Should we have blind faith in liver volumetry? SCR 2019: doi: 10.31487/j.SCR.2019.01.003.

Lo RC, Kim H. Histopathological evaluation of liver fibrosis and cirrhosis regression. Clin Mol Hepatol 2017;23:302–7.

Karlo C, Reiner CS, Stolzmann P, Breitenstein S, Marincek B, Weishaupt D, et al. CT- and MRI-based volumetry of resected liver specimen: Comparison to intraoperative volume and weight measurements and calculation of conversion factors. European J Radiol 2010;75:e107–11.

Bozkurt B, Emek E, Arikan T, Ceyhan O, Yazici P, Sahin T, et al. Liver graft volume estimation by manual volumetry and software-aided interactive volumetry: which is better? Transplant proceedings 2019;51:2387–90.

Suzuki K, Epstein ML, Kohlbrenner R, Garg S, Hori M, Oto A, et al. Quantitative radiology: automated CT liver volumetry compared with interactive volumetry and manual volumetry. American J Roentgenol 2011;197:W706–12.

Lodewick TM, Arnoldussen CWKP, Lahaye MJ, van Mierlo KMC, Neumann UP, Beets-Tan RG, et al. Fast and accurate liver volumetry prior to hepatectomy. HPB 2016;18:764–72.

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Published

2022-07-22

How to Cite

1.
Eurboonyanun K, Eurboonyanun C, Promsorn J, Phaorod J, Srisuk T, Chamadol N, Harisinghani M. The Correlation between the CT Liver Volume and the Actual Weight of the Resected Cirrhotic Liver in Transplantation Patients. J Health Sci Med Res [Internet]. 2022 Jul. 22 [cited 2024 Dec. 23];40(4):437-4. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/257760

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Original Article