Liver planning software accurately predicts postoperative liver volume and measures early regeneration Journal Article
| Authors: | Simpson, A. L.; Geller, D. A.; Hemming, A. W.; Jarnagin, W. R.; Clements, L. W.; D'Angelica, M. I.; Dumpuri, P.; Gonen, M.; Zendejas, I.; Miga, M. I.; Stefansic, J. D. |
| Article Title: | Liver planning software accurately predicts postoperative liver volume and measures early regeneration |
| Abstract: | Background Postoperative or remnant liver volume (RLV) after hepatic resection is a critical predictor of perioperative outcomes. This study investigates whether the accuracy of liver surgical planning software for predicting postoperative RLV and assessing early regeneration. Study Design Patients eligible for hepatic resection were approached for participation in the study from June 2008 to 2010. All patients underwent cross-sectional imaging (CT or MRI) before and early after resection. Planned remnant liver volume (pRLV) (based on the planned resection on the preoperative scan) and postoperative actual remnant liver volume (aRLV) (determined from early postoperative scan) were measured using Scout Liver software (Pathfinder Therapeutics Inc.). Differences between pRLV and aRLV were analyzed, controlling for timing of postoperative imaging. Measured total liver volume (TLV) was compared with standard equations for calculating volume. Results Sixty-six patients were enrolled in the study from June 2008 to June 2010 at 3 treatment centers. Correlation was found between pRLV and aRLV (r = 0.941; p < 0.001), which improved when timing of postoperative imaging was considered (r = 0.953; p < 0.001). Relative volume deviation from pRLV to aRLV stratified cases according to timing of postoperative imaging showed evidence of measurable regeneration beginning 5 days after surgery, with stabilization at 8 days (p < 0.01). For patients at the upper and lower extremes of liver volumes, TLV was poorly estimated using standard equations (up to 50% in some cases). Conclusions Preoperative virtual planning of future liver remnant accurately predicts postoperative volume after hepatic resection. Early postoperative liver regeneration is measureable on imaging beginning at 5 days after surgery. Measuring TLV directly from CT scans rather than calculating based on equations accounts for extremes in TLV. © 2014 by the American College of Surgeons. |
| Keywords: | adult; controlled study; aged; major clinical study; postoperative period; liver cell carcinoma; liver cirrhosis; nuclear magnetic resonance imaging; cancer diagnosis; computer assisted tomography; tumor volume; deep vein thrombosis; kidney failure; confidence interval; heart failure; liver resection; pleura effusion; bsa; bile duct carcinoma; liver regeneration; seroma; wound dehiscence; health care planning; liver weight; metastatic colorectal cancer; acute respiratory failure; body surface; abdominal bleeding; respiratory distress; memorial sloan-kettering cancer center; mskcc; ci; liver size; human; male; female; priority journal; article; abbreviations and acronyms; actual remnant liver volume; arlv; body surface area; interquartile range; iqr; planned remnant liver volume; prlv; tflv; tlv; total functional liver volume; total liver volume; university of pittsburgh medical center; upmc; dimensional measurement accuracy |
| Journal Title: | Journal of the American College of Surgeons |
| Volume: | 219 |
| Issue: | 2 |
| ISSN: | 1072-7515 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2014-08-01 |
| Start Page: | 199 |
| End Page: | 207 |
| Language: | English |
| DOI: | 10.1016/j.jamcollsurg.2014.02.027 |
| PROVIDER: | scopus |
| PMCID: | PMC4128572 |
| PUBMED: | 24862883 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2014 -- CODEN: JACSE -- Source: Scopus |
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906Jarnagin -
780D'Angelica -
64Simpson
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