VOLUMETRY IN MAJOR LIVER RESECTION
Keywords:
volumetry, «major» liver resections, acute liver failure.Abstract
Summary. Introduction: future liver remnant is a critical factor in hepatobiliary surgery, because it represents
a potential risk of acute liver failure in postoperative period. The reasonability of routine volumetry prior to liver transplantation is unquestionable. However, there is
a lack of clear recommendations for this procedure in the
cohort of patients with planned liver resection. The aim
was to analyze the results of own experience and current literature data precision for determining the optimal approach to the volumery before major liver resection. Object and methods: the survey included 15 cases
whom volumetry performed retrospectively by radiologists with ≥ 7 years of experience in abdominal computed
tomography (CT)/magnetic resonance imaging (MRI).
All patients were those who underwent «major» liver resections due to liver malignancies or its metastatic injuries during the period March, 2014 –December, 2015
in the clinic of National Cancer Institute. Calculation
of the liver and its sections/segments volume has been
done using operational CT stations and specialized software (Extended Brilliance Workstation, Philips, Eindhoven, the Netherlands; Onis 2.5 and Varian Eclipse)
from the facilities of Institute. Results: the median of total liver volume was 1784.1 ± 72.0; 1763.3 ± 94.0 and
1799.9 ± 81.0 cm3
when Philips Workstation, Onis 2.5
and Varian Eclipse used, respectively (р = 0.54). Future liver remnant median was 375.4 ± 115.0; 368.7 ±
111.0 and 397.9 ± 110.0 cm3
with mentioned above programs, respectively (р = 0.73). The manual volumetry
was the most time-consuming both with Philips Workstation (42 ± 12 min), and in Onis 2.5 (51 ± 8 min),
whereas the semi-automatic method (Varian Eclipse)
subjectively allowed to save radiologist’s time and it comprised 29 ± 5 min. Conclusions: analysis of obtained results and literature data demonstrate high importance
of the carried out studies and indicate reliable correlation between manual and semi-automatic methods of
volumetric measurements of liver and its separate segments/sections. It was demonstrated that volumetry of
liver and its separate anatomic structures on the stage of
«major» resections planning is a necessary point in preoperative examination of the calculation of minimally
permissible tissue volume in these patients.
References
Kingham TP, Correa-Gallego C, D’Angelica MI, et al. Hepatic parenchymal preservation surgery: decreasing morbidity and mortality rates in 4,152 resections for malignancy. J Am Coll Surg 2015; 220 (4): 471–9.
Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011; 149 (5): 713–24.
Kawano Y, Sasaki A, Kai S, et al. Short- and long-term outcomes after hepatic resection for hepatocellular carcinoma with concomitant esophageal varices in patients with cirrhosis. Ann Surg Oncol 2008; 15: 1670–6.
Burlaka АА, Kolesnik ОО. Principles of acute liver failure detection and its management in early post-operative period (review of literature). Oncology 2016; 18 (1): 1–5.
D’Onofrio M, DeRobertis R, Demozzi E, et al. Liver volumetry: Is imaging reliable? Personal experience and review of the literature. World J Radiol 2014; 6 (4): 62–71.
Michalopoulos GK, DeFrances MC. Liver regeneration. Science 1997; 276: 60–6.
Kitajima K, Taboury J, Boleslawski E, et al. Sonographic preoperative assessment of liver volume before major liver resection. Gastroenterol Clin Biol 2008; 32: 382–9.
Aoyama M, Nakayama Y, Awai K, et al. A simple method for accurate liver volume estimation by use of curve-fitting: a pilot study. Radiol Phys Technol 2013; 6: 180–6.
Zappa M, Dondero F, Sibert A, et al. Liver regeneration at day 7 after right hepatectomy: global and segmental volumetric analysis by using CT. Radiology 2009; 252: 426–32.
Vienne A, Hobeika E, Gouya H, et al. Prediction of drainage effectiveness during endoscopic stenting of malignant hilar strictures: the role of liver volume assessment. Gastrointest Endosc 2010; 72: 728–35.
Kalkmann J, Forsting M, Stattaus J. Liver volume variations as a parameter to assess therapy response in advanced metastatic liver disease. Onkologie 2011; 34: 30–4.
Numminen K, Sipilä O, Mäkisalo H. Preoperative hepatic 3D models: virtual liver resection using three-dimensional imaging technique. Eur J Radiol 2005; 56: 179–84.
Mokry T, Bellemann N, Muller D, et al. Accuracy of estimation of graft size for living-related liver transplantation: first results of a semi-automated interactive software for CT-volumetry. PLoS One 2014; 9 (10): e110201.
Karlo C, Reiner CS, Stolzmann P, et al. CT- and MRIbased volumetry of resected liver specimen: comparison to intraoperative volume and weight measurements and calculation of conversion factors. Eur J Radiol 2010; 75: 107–11.
Tongyoo A, Pomfret EA, Pomposelli JJ. Accurate estimation of living donor right hemi-liver volume from portal vein diameter measurement and standard liver volume calculation. Am J Transplant 2012; 12: 1229–39.
Saeki I, Tokunaga S, Matsuura T, et al. A formula for determining the standard liver volume in children: a special reference for neonates and infants. Pediatr Transplant 2012; 16: 244–9.
Lee J, Kim KW, Kim SY, et al. Feasibility of semiautomated MR volumetry using gadoxetic acid-enhanced MRI at hepatobiliary phase for living liver donors. Magn Reson Med 2014; 72 (3): 640–5.
Ribero D, Amisano M, Bertuzzo F, et al. Measured versus estimated total liver volume to preoperatively assess the adequacy of the future liver remnant: which method should we use? Ann Surg 2013; 258: 801–6.
Chun YS, Ribero D, Abdalla EK, et al. Comparison of two methods of future liver remnant volume measurement. J Gastrointest Surg 2008; 12: 123–8.
Vauthey JN, Chaoui A, Do KA, et al. Standardized measurement of the future liver remnant prior to extended liver resection: methodology and clinical associations. Surgery 2000; 127: 512–9.
Muller SA, Blauer K, Kremer M, et al. Exact CT-based liver volume calculation including nonmetabolic liver tissue in threedimensional liver reconstruction. J Surg Res 2014; 160: 236–43.
Kayashima H, Taketomi A, Yonemura Y, et al. Accuracy of an age-adjusted formula in assessing the graft volume in living donor liver transplantation. Liver Transpl 2008; 14: 136671.
Suzuki K, Epstein ML, Kohlbrenner R, et al. Quantitative radiology: automated CT liver Volumetry compared with
interactive volumetry and manual volumetry. Am J Roentgenol 2011; 197: 706–712.
Nakayama Y, Li Q, Katsuragawa S, et al. Automated hepatic volumetry for living related liver transplantation at multisection CT. Radiology 2006; 240: 743–8.
Soyer P, Sirol M, Dohan A, et al. Hepatic height on coronal computed tomography images predicts total liver volume in European adults without liver disease. Dig Dis Sci 2012; 57: 1692–97.
Suzuki K, Huynh HT, Liu Y. et al. Computerized segmentation of liver in hepatic CT and MRI by means of level-set geodesic active contouring. Conf Proc IEEE Eng Med Biol Soc 2013; vol. 2013, 2984–7.
Dello SA, Stoot JH, van Stiphout RS, et al. Prospective volumetric assessment of the liver on a personal computer by
nonradiologists prior to partial hepatectomy. World J Surg 2011; 35: 386–92.
