Journal article
Liver planning software accurately predicts postoperative liver volume and measures early regeneration
Journal of the American College of Surgeons, Vol.219(2), pp.199-207
08/2014
DOI: 10.1016/j.jamcollsurg.2014.02.027
PMCID: PMC4128572
PMID: 24862883
Abstract
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.
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.
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).
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.
Details
- Title: Subtitle
- Liver planning software accurately predicts postoperative liver volume and measures early regeneration
- Creators
- Amber L Simpson - Memorial Sloan Kettering Cancer CenterDavid A Geller - University of Pittsburgh Medical CenterAlan W Hemming - University of California San DiegoWilliam R Jarnagin - Memorial Sloan Kettering Cancer CenterLogan W Clements - Vanderbilt UniversityMichael I D'Angelica - Memorial Sloan Kettering Cancer CenterPrashanth Dumpuri - Pathfinder Therapeutics Inc., Nashville, TN.Mithat Gönen - Memorial Sloan Kettering Cancer CenterIvan Zendejas - University of FloridaMichael I Miga - Vanderbilt UniversityJames D Stefansic - Pathfinder Therapeutics Inc., Nashville, TN.
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Surgeons, Vol.219(2), pp.199-207
- DOI
- 10.1016/j.jamcollsurg.2014.02.027
- PMID
- 24862883
- PMCID
- PMC4128572
- NLM abbreviation
- J Am Coll Surg
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Grant note
- P30 CA008748 / NCI NIH HHS R44 CA119502 / NCI NIH HHS R01 CA162477 / NCI NIH HHS
- Language
- English
- Date published
- 08/2014
- Academic Unit
- Surgery
- Record Identifier
- 9984321870302771
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