CT- and MRI-based volumetry of resected liver specimen: comparison to intraoperative volume and weight measurements and calculation of conversion factors.

OBJECTIVE To compare virtual volume to intraoperative volume and weight measurements of resected liver specimen and calculate appropriate conversion factors to reach better correlation. METHODS Preoperative (CT-group, n=30; MRI-group, n=30) and postoperative MRI (n=60) imaging was performed in 60 patients undergoing partial liver resection. Intraoperative volume and weight of the resected liver specimen was measured. Virtual volume measurements were performed by two readers (R1,R2) using dedicated software. Conversion factors were calculated. RESULTS Mean intraoperative resection weight/volume: CT: 855 g/852 mL; MRI: 872 g/860 mL. Virtual resection volume: CT: 960 mL(R1), 982 mL(R2); MRI: 1112 mL(R1), 1115 mL(R2). Strong positive correlation for both readers between intraoperative and virtual measurements, mean of both readers: CT: R=0.88(volume), R=0.89(weight); MRI: R=0.95(volume), R=0.92(weight). Conversion factors: 0.85(CT), 0.78(MRI). CONCLUSION CT- or MRI-based volumetry of resected liver specimen is accurate and recommended for preoperative planning. A conversion of the result is necessary to improve intraoperative and virtual measurement correlation. We found 0.85 for CT- and 0.78 for MRI-based volumetry the most appropriate conversion factors.

[1]  W. Jochum,et al.  Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinoma. , 2006, Journal of hepatology.

[2]  H. Petrowsky,et al.  Strategies for safer liver surgery and partial liver transplantation. , 2007, The New England journal of medicine.

[3]  R Felix,et al.  [Accuracy of the CT-estimated weight of the right hepatic lobe prior to living related liver donation (LRLD) for predicting the intraoperatively measured weight of the graft]. , 2003, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[4]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[5]  C E Broelsch,et al.  Preoperative Volume Prediction in Adult Living Donor Liver Transplantation: How Much Can We Rely on It? , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[6]  Peter Neuhaus,et al.  Living donor right liver lobes: preoperative CT volumetric measurement for calculation of intraoperative weight and volume. , 2006, Radiology.

[7]  J. Debatin,et al.  Evaluation of living liver donors with an all-inclusive 3D multi-detector row CT protocol. , 2006, Radiology.

[8]  S J Wigmore,et al.  The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection , 2005, Gut.

[9]  A Roche,et al.  Hepatic metastases from colorectal cancer: influence of hepatic volumetric analysis on surgical decision making. , 1992, Radiology.

[10]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[11]  N. Hosten,et al.  [CT volumetry of the liver before transplantation]. , 1997, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[12]  Diego R Martin,et al.  Imaging of liver metastases: MRI , 2007, Cancer imaging : the official publication of the International Cancer Imaging Society.

[13]  Kunio Doi,et al.  Automated hepatic volumetry for living related liver transplantation at multisection CT. , 2006, Radiology.

[14]  J. Fujimoto,et al.  Impact of Preoperative Planning Using Virtual Segmental Volumetry on Liver Resection for Hepatocellular Carcinoma , 2007, World Journal of Surgery.

[15]  R. Taub.  Liver regeneration: from myth to mechanism , 2004, Nature Reviews Molecular Cell Biology.

[16]  Luca Viganò,et al.  Postoperative Liver Dysfunction and Future Remnant Liver: Where Is the Limit? , 2007, World Journal of Surgery.

[17]  N. Fausto,et al.  Liver regeneration , 2006, Hepatology.

[18]  Shinji Uemoto,et al.  GRAFT SIZE ASSESSMENT AND ANALYSIS OF DONORS FOR LIVING DONOR LIVER TRANSPLANTATION USING RIGHT LOBE 1,2 , 2001, Transplantation.

[19]  N. Yamanaka,et al.  Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. , 1994, Cancer treatment and research.

[20]  P. Neuhaus,et al.  CT-Volumetrie der Leber vor Transplantation , 1997 .

[21]  J M Bland,et al.  Statistical methods for assessing agreement between two methods of clinical measurement , 1986 .

[22]  K. M. Park,et al.  Correlation of blood-free graft weight and volumetric graft volume by an analysis of blood content in living donor liver grafts. , 2002, Transplantation proceedings.