Liver volume measurement by spiral CT: An in vitro study☆
Introduction
Liver volume measurement has many clinical and research uses. For example, liver volume per unit body weight correlates well with functional reserve in cirrhotic patients with liver tumors [1]. It is also useful to assess the progress of various hepatic failures [2]. Measurements of liver volume can be useful to make surgical decisions regarding hepatic resection, to plan radiotherapy dosimetry and to assess responses to treatment [3], [4], [5]. In liver transplantation, graft size is a major criterion for success. A graft that is too large for a recipient is at a higher risk of poor perfusion and poor function [6]. Contrary, too small graft is associated with liver failure or initial nonfunction. Recently, living-related liver transplantation has been performed by removing a segment or a lobe of liver from a living human donor. In these cases, accurate measurements of segmental liver volumes are important for both the donor and the recipient. The purpose of the present study is to evaluate experimentally the accuracy and reproducibility of spiral computed tomography (CT) in measuring liver volume.
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Material and methods
To determine the accuracy of spiral CT system, nine fresh (non-formalin-fixed) sheep livers were scanned in vitro. The CT study was done with a Tomoscan AV Spiral CT (Philips, Netherlands). The collimation was 7 mm. The CT sections were stored on floppy disks and the images were transferred to the workstation that contained software Easyvision (Microsoft, Seattle, USA) for volume measurement. Volumes were measured by two observers (A.O. and M.O.). Reference actual liver volumes were obtained
Results
Liver volume measurements of two methods were showed in Table 1. The mean volume for spiral CT is 912±497 ml and the actual reference volume is 912±527 ml. The correlation between the CT system and actual reference measurement of sheep liver volumes was very strong. The correlation coefficient r was .998 (P<.001) on 7-mm sections. The mean difference between liver volume measurements was 4.95±3.23%. It took 20 s for one liver to measure the volume on CT scan. In the nine livers, an average of
Discussion
Accurate, noninvasive measurement of the liver has potential clinical applications and is an important element in the preoperative evaluation of the liver transplant recipient. Liver volume has been difficult to determine in vivo prior to the advent of cross-sectional imaging, and early results in measuring liver volume with radionuclide scans or ultrasound have not gained widespread clinical applications [7], [8]. The results of the present study show that measurement of liver volumes by
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This article was presented at the 10th Anniversary of Eurosurgery, Istanbul, Turkey, 20–24 June 2000.