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01-07-2021 | Computed Tomography | Hepatobiliary

Predictive value of combined computed tomography volumetry and magnetic resonance elastography for major complications after liver resection

Authors: Kazu Shibutani, Masahiro Okada, Jitsuro Tsukada, Kenji Ibukuro, Hayato Abe, Naoki Matsumoto, Yutaka Midorikawa, Mitsuhiko Moriyama, Tadatoshi Takayama

Published in: Abdominal Radiology | Issue 7/2021

Abstract

Purpose

To retrospectively compare the predictive value of computed tomography volumetry (CTV), magnetic resonance elastography (MRE) of the liver, and their combination for major complications after liver resection.

Methods

We enrolled 108 consecutive patients who underwent anatomical liver resection for liver tumors and preoperative contrast-enhanced CT and MRE. The future liver remnant (FLR) ratio was calculated by CTV, while the liver stiffness measurement (LSM) was obtained by MRE. FLR ratio alone, LSM alone, and combined FLR ratio and LSM were evaluated to predict major complications (Clavien–Dindo grade ≥ IIIa). Univariate and multivariate analyses of hepatic biochemical parameters and imaging data were performed to identify predictors of major complications. Receiver operating characteristic analyses of FLR ratio, LSM, and their combination were performed, and the sensitivity and specificity were calculated.

Results

Twenty-two (20.4%) of the 108 patients experienced major complications. According to multiple regression analysis, the FLR ratio (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.91–0.99, p = 0.040) and LSM (OR 1.72, 95% CI 1.01–2.94, p = 0.047) were independent predictors of major complications. The combined FLR ratio and LSM were predictive of major complications, with an area under the curve (AUC) of 0.818, sensitivity of 68.2%, and specificity of 84.9%. The AUC and specificity for combined FLR ratio and LSM were larger than those for FLR ratio (AUC: 0.711, specificity: 80.2%) and LSM (AUC: 0.793, specificity: 80.2%).

Conclusion

Combined CTV and MRE analysis can improve the AUC and specificity for predicting major complications after anatomical liver resection.

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Title: Predictive value of combined computed tomography volumetry and magnetic resonance elastography for major complications after liver resection
Authors: Kazu Shibutani
Masahiro Okada
Jitsuro Tsukada
Kenji Ibukuro
Hayato Abe
Naoki Matsumoto
Yutaka Midorikawa
Mitsuhiko Moriyama
Tadatoshi Takayama
Publication date: 01-07-2021
Publisher: Springer US
Keywords: Computed Tomography
Computed Tomography
Liver Resection
Liver Resection
Published in: Abdominal Radiology / Issue 7/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-021-02991-3

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