Quantitative liver health imaging improves clinical outcomes in colorectal liver metastasis surgery.

Introduction Post-hepatectomy liver failure (PHLF), driven by insufficient volume and quality of the remnant liver following an operation, is a significant clinical problem that is currently underserved by pre-operative assessment methods. Clinical management and a patient's recovery from post-operative liver related complications results in a protracted stay in hospital. Methods 91 patients with colorectal liver metastasis being considered for liver resection were recruited onto the Precision1 trial. The imaging report from an additional non-quantitative multiparametric MRI (mpMRI) scan was examined and used to alter surgical decision making. Patient outcomes were monitored and evaluated against a standard of care comparator dataset blinded to mpMRI scan results. Results Previously undiagnosed liver disease activity or elevated liver fat was detected using mpMRI in 23% of patients, whereas the liver health was unexpectedly good in 7% of patients; this resulted in a change to surgical plan in 29% of cases. The incidence of protracted (over 14 days) length of stay was reduced from 5% to 1% following the introduction of mpMRI reports into surgical decision-making process. Conclusion mpMRI is a safe method to evaluate liver health in patients being considered for liver resection. Surgical decision making can be altered to achieve a safer treatment strategy resulting in shorter hospital stays for patients.