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Accuracy of estimation of graft size for living-related liver transplantation

Publication
Philips CT Clinical Science Philips Healthcare • USA

First results of a semi-automated interactive software for CT-volumetry

Mokry T, Bellemann N, Muller D, Bermejo JL, Klauß M , Stampfl U, Radeleff B, Schemmer P, Kauczor HU, Sommer CM.

* This article originally published in the October 2014 issue of PLOS One.
Objectives
To evaluate accuracy of estimated graft size for living-related liver transplantation using a semi-automated interactive software for CT-volumetry.

Materials and Methods
Sixteen donors for living-related liver transplantation (11 male; mean age: 38.269.6 years) underwent contrast-enhanced CT prior to graft removal. CT-volumetry was performed using a semi-automated interactive software (P), and compared with a manual commercial software (TR). For P, liver volumes were provided either with or without vessels. For TR, liver volumes were provided always with vessels. Intraoperative weight served as reference standard. Major study goals included analyses of volumes using absolute numbers, linear regression analyses and interobserver agreements. Minor study goals included the description of the software workflow: degree of manual correction, speed for completion, and overall intuitiveness using five-point Likert scales:
  1. Markedly lower/faster/higher for P compared with TR
  2. Slightly lower/faster/higher for P compared with TR
  3. Identical for P and TR
  4. Slightly lower/faster/ higher for TR compared with P
  5. Markedly lower/faster/higher for TR compared with P

Results
Liver segments II/III, II–IV and V–VIII served in six, three, and seven donors as transplanted liver segments. Volumes were 642.96368.8 ml for TR with vessels, 623.86349.1 ml for P with vessels, and 605.26345.8 ml for P without vessels (P,0.01). Regression equations between intraoperative weights and volumes were y = 0.94x+30.1 (R2 = 0.92; P,0.001) for TR with vessels, y = 1.00x+12.0 (R2 = 0.92; P,0.001) for P with vessels, and y = 1.01x+28.0 (R2 = 0.92; P,0.001) for P without vessels. Inter-observer agreement showed a bias of 1.8 ml for TR with vessels, 5.4 ml for P with vessels, and 4.6 ml for P without vessels. For the degree of manual correction, speed for completion and overall intuitiveness, scale values were 2.660.8, 2.460.5 and 2.

Conclusions
CT-volumetry performed with P can predict accurately graft size for living-related liver transplantation while improving workflow compared with TR.


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Publication
IntelliSpace Portal
abdomen, Body, contrast-enhanced, liver, Liver Analysis
 

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