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Assessment of liver fibrosis severity using computed tomography–based liver and spleen volumetric indices in patients with chronic liver disease

Abstract

Objectives

To evaluate whether the liver and spleen volumetric indices, measured on portal venous phase CT images, could be used to assess liver fibrosis severity in chronic liver disease.

Methods

From 2007 to 2017, 558 patients (mean age 48.7 ± 13.1 years; 284 men and 274 women) with chronic liver disease (n = 513) or healthy liver (n = 45) were retrospectively enrolled. The liver volume (sVolL) and spleen volume (sVolS), normalized to body surface area and liver-to-spleen volume ratio (VolL/VolS), were measured on CT images using a deep learning algorithm. The correlation between the volumetric indices and the pathologic liver fibrosis stages combined with the presence of decompensation (F0, F1, F2, F3, F4C [compensated cirrhosis], and F4D [decompensated cirrhosis]) were assessed using Spearman’s correlation coefficient. The performance of the volumetric indices in the diagnosis of advanced fibrosis, cirrhosis, and decompensated cirrhosis were evaluated using the area under the receiver operating characteristic curve (AUC).

Results

The sVolS (ρ = 0.47–0.73; p < .001) and VolL/VolS (ρ = −0.77–− 0.48; p < .001) showed significant correlation with liver fibrosis stage in all etiological subgroups (i.e., viral hepatitis, alcoholic and non-alcoholic fatty liver, and autoimmune diseases), while the significant correlation of sVolL was noted only in the viral hepatitis subgroup (ρ = − 0.55; p < .001). To diagnose advanced fibrosis, cirrhosis, and decompensated cirrhosis, the VolL/VolS (AUC 0.82–0.88) and sVolS (AUC 0.82–0.87) significantly outperformed the sVolL (AUC 0.63–0.72; p < .001).

Conclusion

The VolL/VolS and sVolS may be used for assessing liver fibrosis severity in chronic liver disease.

Key Points

• Volumetric indices of liver and spleen measured on computed tomography images may allow liver fibrosis severity to be assessed in patients with chronic liver disease.

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Abbreviations

APRI:

Aspartate aminotransferase-to-platelet ratio index

AUC:

Area under the receiver operating characteristic curve

BSA:

Body surface area

CNN:

Convolutional neural network

MELD score:

Model for End-Stage Liver Disease score

NAFLD:

Non-alcoholic fatty liver disease

sVolL :

Standardized liver volume

sVolS :

Standardized spleen volume

VolL/VolS :

Liver-to-spleen volume ratio

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Funding

This research was supported by (1) the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1A2B4003114); (2) the Bio and Medical Technology Development Program of the NRF, which is funded by the Ministry of Science and ICT (NRF-2016M3A9A7918706).

Author information

Correspondence to Seung Soo Lee.

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Guarantor

The scientific guarantor of this publication is Seung Soo Lee.

Conflict of interest

The authors have no conflicts of interest relevant to this research to disclose.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

The CT and pathology data of our study population were reported in a previous study (Radiology 2018; 289: 688–697).

Methodology

• retrospective

• diagnostic or prognostic study

• multicenter study

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Son, J.H., Lee, S.S., Lee, Y. et al. Assessment of liver fibrosis severity using computed tomography–based liver and spleen volumetric indices in patients with chronic liver disease. Eur Radiol (2020). https://doi.org/10.1007/s00330-020-06665-4

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Keywords

  • Liver fibrosis
  • Multidetector computed tomography
  • Organ volume
  • Deep learning