Assessment of liver fibrosis severity using computed tomography–based liver and spleen volumetric indices in patients with chronic liver disease

Son, Jung Hee; Lee, Seung Soo; Lee, Yedaun; Kang, Bo Kyeong; Sung, Yu Sub; Jo, So Ra; Yu, Eunsil

doi:10.1007/s00330-020-06665-4

Cited by 52 publications

(39 citation statements)

References 28 publications

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“…Our DLA may be used for monitoring liver regeneration after liver resection ( 2 ). In patients with CLD, spleen volume and the liver/spleen volume ratio may be used as quantitative imaging biomarkers to assess the severity of CLD and portal hypertension, as suggested by previous studies ( 5 6 7 8 9 10 ). The actual utility and clinical implications of our DLA should be evaluated in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Liver volume measurement is important for evaluating potential liver donors and patients who will undergo liver resection as remnant liver volume after hepatic resection is a major predictor of postoperative hepatic dysfunction and morbidity ( 1 2 3 4 ). Whole liver and spleen volume measurements also have clinical implications as the spleen volume and the liver to spleen volume ratio are associated with the severity of liver fibrosis and portal hypertension in patients with chronic liver disease (CLD) ( 5 6 7 8 9 10 ). Computed tomography (CT) volumetry is considered to be the most reliable noninvasive method for the volume measurement of abdominal organs.…”

Section: Introductionmentioning

confidence: 99%

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Deep Learning Algorithm for Automated Segmentation and Volume Measurement of the Liver and Spleen Using Portal Venous Phase Computed Tomography Images

et al. 2020

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Objective: Measurement of the liver and spleen volumes has clinical implications. Although computed tomography (CT) volumetry is considered to be the most reliable noninvasive method for liver and spleen volume measurement, it has limited application in clinical practice due to its time-consuming segmentation process. We aimed to develop and validate a deep learning algorithm (DLA) for fully automated liver and spleen segmentation using portal venous phase CT images in various liver conditions. Materials and Methods: A DLA for liver and spleen segmentation was trained using a development dataset of portal venous CT images from 813 patients. Performance of the DLA was evaluated in two separate test datasets: dataset-1 which included 150 CT examinations in patients with various liver conditions (i.e., healthy liver, fatty liver, chronic liver disease, cirrhosis, and post-hepatectomy) and dataset-2 which included 50 pairs of CT examinations performed at ours and other institutions. The performance of the DLA was evaluated using the dice similarity score (DSS) for segmentation and Bland-Altman 95% limits of agreement (LOA) for measurement of the volumetric indices, which was compared with that of ground truth manual segmentation. Results: In test dataset-1, the DLA achieved a mean DSS of 0.973 and 0.974 for liver and spleen segmentation, respectively, with no significant difference in DSS across different liver conditions (p = 0.60 and 0.26 for the liver and spleen, respectively). For the measurement of volumetric indices, the Bland-Altman 95% LOA was-0.17 ± 3.07% for liver volume and-0.56 ± 3.78% for spleen volume. In test dataset-2, DLA performance using CT images obtained at outside institutions and our institution was comparable for liver (DSS, 0.982 vs. 0.983; p = 0.28) and spleen (DSS, 0.969 vs. 0.968; p = 0.41) segmentation. Conclusion: The DLA enabled highly accurate segmentation and volume measurement of the liver and spleen using portal venous phase CT images of patients with various liver conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Deep Learning Algorithm for Automated Segmentation and Volume Measurement of the Liver and Spleen Using Portal Venous Phase Computed Tomography Images

et al. 2020

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“…Therefore, in this study, we imported patient CT imaging into a Monaco system, delineated the target organ slice by slice, designed the target area for radiotherapy and estimated the volume of the target organ, thereby effectively demonstrating splenic changes. [19][20][21] In our study, we identified splenic shrinkage in 27.7% of patients. In addition to comparisons of lymphocyte levels in COVID-19 patients, changes in spleen volumes and ratios of spleen volume to patient (skin) volume may also predict changes in the immune status of patients with mild and more severe disease.…”

Section: Discussionmentioning

confidence: 53%

“…Splenic atrophy has also been reported during pathological examinations of COVID‐19 patients; 17,18 however, most changes in spleen volume cannot be measured by pathology directly. Therefore, in this study, we imported patient CT imaging into a Monaco system, delineated the target organ slice by slice, designed the target area for radiotherapy and estimated the volume of the target organ, thereby effectively demonstrating splenic changes 19‐21 …”

Section: Discussionmentioning

confidence: 99%

“…17,18 Splenic volume changes, however, cannot adequately be measured by pathological analysis in most patients; therefore, we used a Monaco system in this study, which is generally used to show splenic changes during radiotherapy planning. [19][20][21] We imported CT scans of selected patients into the Monaco treatment planning system and delineated the outline of the spleen, with a CT slice thickness of 5 mm. Spleen and patient(skin) volumes were directly calculated using the volume estimation function of the software after outlines of the spleen and patient (skin) were delineated.…”

Section: Case Collectionmentioning

confidence: 99%

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Immunosuppression and cardiovascular dysfunction in patients with severe versus mild coronavirus disease 2019: a case series

Bao

Fang

et al. 2020

Clin & Trans Imm

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Objectives. As coronavirus disease 2019 (COVID-19) continues to spread globally, we aimed to describe and compare changes in the immune and cardiovascular systems of patients with mild versus severe COVID-19 at different time points during the course of disease. Methods. One hundred and one patients diagnosed with COVID-19 who underwent serial peripheral blood collection and chest computed tomography (CT) imaging were enrolled in this study and grouped by the severity of their illness. Changes in the immune and cardiovascular systems were analysed and compared between groups. Results. The study included 43 women and 58 men, with a median age of 45 years (interquartile range [IQR], 16-71). We identified spleen shrinkage in 27.7% of study patients. Ratios of spleen volume to patient (skin) volume were compared, with evidence that severe patients had more splenic shrinkage than mild patients. Lymphopenia was observed in 65.3% of patients, and 27.3% of patients had persistently low levels of lymphocytes after discharge. Tachycardia occurred mainly during the first 2 days of hospitalisation, with increases in creatine kinase-myocardial band levels in 10 (9.9%) patients and arrhythmias in 16 (15.8%) patients. Conclusions. In addition to pulmonary manifestations, our study demonstrated that other organ systems can also be affected during COVID-19 infection, with evidence of immunosuppression and cardiovascular dysfunction, which may contribute to increased mortality rates in critically ill COVID-19 patients.

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Noninvasive staging of liver fibrosis: review of current quantitative CT and MRI-based techniques

Im¹,

Song

Jang

2021

Abdom Radiol

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Assessment of liver fibrosis severity using computed tomography–based liver and spleen volumetric indices in patients with chronic liver disease

Cited by 52 publications

References 28 publications

Deep Learning Algorithm for Automated Segmentation and Volume Measurement of the Liver and Spleen Using Portal Venous Phase Computed Tomography Images

Deep Learning Algorithm for Automated Segmentation and Volume Measurement of the Liver and Spleen Using Portal Venous Phase Computed Tomography Images

Immunosuppression and cardiovascular dysfunction in patients with severe versus mild coronavirus disease 2019: a case series

Noninvasive staging of liver fibrosis: review of current quantitative CT and MRI-based techniques

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