AUTOMATED CT- VOLUMETRY OF RESECTED LIVER SPECIMEN: COMPARISON TO INTRAOPERATIVE VOLUME AND WEIGHT MEASUREMENTS AND CALCULATION
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 4241-4252
AbstractBackground: With rapid growth of machine learning and image analysis techniques, highly accurate CT automatic volumetry methods may substitute for the manual method in clinical liver volume calculation and giving a close correlation between intra-operative liver volume or weight measurements and virtually measured liver volume. The purpose of our study is to evaluate the effectiveness and advantages of automated CT volumetry in the assessment of liver volume in living donor liver transplantation and to compare this technique and its results with those calculated intra-operatively.
Material and Methods: Between February 2017 till February 2019 comparative study was conducted on dynamic contrast enhanced hepatic CT scans of 16 potential living liver donors in Theodor Bilharz Research Institute. The potential donors were investigated using 32 channel multi-detector rows CT scanner (Alexion; Toshiba medical systems) and Automated CT liver volumetry was performed on Myrian workstation using Myrian® XP-Liver software. Potential donors underwent liver transplantation; consequently post-operative weights of the graft were available for comparison with automated CT volumetry results.
Results: After collection of data from preoperative automated volumetry and actual graft weights, we analyzed the degree of difference between the real graft weight and preoperative automated volumetry of the right lobe excluding middle hepatic vein. The average processing time for the automated volumetry was 3.09 ± 0.44 min/case (range, 2.37 – 4.02 min/case), The average volume using automated method was 1035.38 ± 115.79 cm3 (range, 883 – 1217 cm3), while the actual graft weight was 930.63 ± 123.24 gm (range, 700 – 1090 gm) which achieved excellent agreement with the actual graft volume without statistical significance (P value = 0.068). We also found that majority of cases show overestimated the graft weight. Our study showed that automated software with 75 % of cases having less than 15% difference from real graft weight using automated CT volumetry.
Conclusion: Automated CT liver volumetry significantly reduced the time required for volumetry of the liver, accurately predicted the preoperative liver volume and provided acceptable measurements intra-operative weight/volume of the grafts that can be considered sufficiently accurate for determination of weight/volume of liver graft for surgery.
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