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01-07-2017 | Hepatobiliary-Pancreas

Hepatosplenic volumetric assessment at MDCT for staging liver fibrosis

Authors: Perry J. Pickhardt, Kyle Malecki, Oliver F. Hunt, Claire Beaumont, John Kloke, Timothy J. Ziemlewicz, Meghan G. Lubner

Published in: European Radiology | Issue 7/2017

Abstract

Purpose

To investigate hepatosplenic volumetry at MDCT for non-invasive prediction of hepatic fibrosis.

Methods

Hepatosplenic volume analysis in 624 patients (mean age, 48.8 years; 311 M/313 F) at MDCT was performed using dedicated software and compared against pathological fibrosis stage (F0 = 374; F1 = 48; F2 = 40; F3 = 65; F4 = 97). The liver segmental volume ratio (LSVR) was defined by Couinaud segments I–III over segments IV–VIII. All pre-cirrhotic fibrosis stages (METAVIR F1-F3) were based on liver biopsy within 1 year of MDCT.

Results

LSVR and total splenic volumes increased with stage of fibrosis, with mean(±SD) values of: F0: 0.26 ± 0.06 and 215.1 ± 88.5 mm³; F1: 0.25 ± 0.08 and 294.8 ± 153.4 mm³; F2: 0.331 ± 0.12 and 291.6 ± 197.1 mm³; F3: 0.39 ± 0.15 and 509.6 ± 402.6 mm³; F4: 0.56 ± 0.30 and 790.7 ± 450.3 mm³, respectively. Total hepatic volumes showed poor discrimination (F0: 1674 ± 320 mm³; F4: 1631 ± 691 mm³). For discriminating advanced fibrosis (≥F3), the ROC AUC values for LSVR, total liver volume, splenic volume and LSVR/spleen combined were 0.863, 0.506, 0.890 and 0.947, respectively.

Conclusion

Relative changes in segmental liver volumes and total splenic volume allow for non-invasive staging of hepatic fibrosis, whereas total liver volume is a poor predictor. Unlike liver biopsy or elastography, these CT volumetric biomarkers can be obtained retrospectively on routine scans obtained for other indications.

Key Points

• Regional changes in hepatic volume (LSVR) correlate well with degree of fibrosis.

• Total liver volume is a very poor predictor of underlying fibrosis.

• Total splenic volume is associated with the degree of hepatic fibrosis.

• Hepatosplenic volume assessment is comparable to elastography for staging fibrosis.

• Unlike elastography, volumetric analysis can be performed retrospectively.

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Title: Hepatosplenic volumetric assessment at MDCT for staging liver fibrosis
Authors: Perry J. Pickhardt
Kyle Malecki
Oliver F. Hunt
Claire Beaumont
John Kloke
Timothy J. Ziemlewicz
Meghan G. Lubner
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4648-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hepatosplenic volumetric assessment at MDCT for staging liver fibrosis

Abstract

Purpose

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Key Points

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