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Abdominal Radiology

, Volume 44, Issue 10, pp 3263–3272 | Cite as

Does providing routine liver volume assessment add value when performing CT surveillance in cirrhotic patients?

  • Milan Patel
  • Pimpitcha Puangsricharoen
  • Hafiz Muhammad Sharjeel Arshad
  • Sam Garrison
  • Witina Techasatian
  • Marwan Ghabril
  • Kumar Sandrasegaran
  • Suthat LiangpunsakulEmail author
  • Mark TannEmail author
Hepatobiliary
  • 64 Downloads

Abstract

Background

The measurement of liver volume (LV) is considered to be an effective prognosticator for postoperative liver failure in patients undergoing hepatectomy. It is unclear whether LV can be used to predict mortality in cirrhotic patients.

Methods

We enrolled 584 consecutive cirrhotic patients who underwent computerized topography (CT) of the abdomen for hepatocellular carcinoma surveillance and 50 age, gender, race, and BMI-matched controls without liver disease. Total LV (TLV), functional LV (FLV), and segmental liver volume (in cm3) were measured from CT imaging. Cirrhotic subjects were followed until death, liver transplantation, or study closure date of July 31, 2016. The survival data were assessed with log-rank statistics and independent predictors of survival were performed using Cox hazards model.

Results

Cirrhotic subjects had significantly lower TLV, FLV, and segmental (all except for segments 1, 6, 7) volume when compared to controls. Subjects presenting with hepatic encephalopathy had significantly lower TLV and FLV than those without HE (p = 0.002). During the median follow-up of 1145 days, 112 (19%) subjects were transplanted and 131 (23%) died. TLV and FLV for those who survived were significantly higher than those who were transplanted or dead (TLV:1740 vs. 1529 vs. 1486, FLV 1691 vs. 1487 vs. 1444, p < 0.0001). In the Cox regression model, age, MELD score, TLV, or FLV were independent predictors of mortality.

Conclusion

Baseline liver volume is an independent predictor of mortality in subjects with cirrhosis. Therefore, it may be useful to provide these data while performing routine surveillance CT scan as an important added value. Further studies are needed to validate these findings and to better understand their clinical utility.

Keywords

Liver Diagnostic imaging Portal hypertension 

Abbreviations

APRI

Aspartate to platelet ratio index

CT

Computer tomography

ELF

Enhanced liver fibrosis

Fib-4

Fibrosis-4

FLV

Functional liver volume

LS

Liver stiffness

MELD

Model for end stage liver disease

TLV

Total liver volume

Notes

Author Contributions

Data collection (MP, PP, MA, SG, and WT), data analysis and interpretation of data (MG, MT, and SL), and manuscript writing, critical review, and corrections (MG, MT, KS, and SL).

Funding

This work was partly supported by VA Merit Award 1I01CX000361 and NIH R01 AA025208 (to S.L).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

261_2019_2145_MOESM1_ESM.docx (857 kb)
Supplementary material 1 (DOCX 856 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of MedicineVirginia Commonwealth UniversityRichmondUSA
  2. 2.Division of Gastroenterology and HepatologyIndiana University School of MedicineIndianapolisUSA
  3. 3.Chulalongkorn UniversityBangkokThailand
  4. 4.University of Illinois at UrbanaUrbanaUSA
  5. 5.Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA
  6. 6.Roudebush Veterans Administration Medical CenterIndianapolisUSA
  7. 7.Department of Biochemistry and Molecular BiologyIndiana University School of MedicineIndianapolisUSA

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