Preoperative liver donor evaluation: Imaging and pitfalls

Mortelé, Koenraad J.; Cantisani, Vito; Troisi, Roberto; Hemptinne, Bernard de; Silverman, Stuart G.

doi:10.1053/jlts.2003.50199

Cited by 49 publications

(36 citation statements)

References 39 publications

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“…However, Schroeder et al [4] found CT to be more accurate in detecting variations in vascular anatomy. This is probably related to the inherently superior spatial resolution of CT compared to MR. Hepatic artery thrombosis (HAT) is one of the most dreaded complications of LT and can be drastically decreased by excluding grafts with unfavorable anatomy [27] . In the past, a potential graft with a narrow hepatic artery of less than 2 mm in diameter was regarded as a contraindication for LDLT due to the high risk of HAT.…”

Section: Hepatic Arterial Systemmentioning

confidence: 99%

“…This is best evaluated on a non-contrast study as relative densities of the liver and spleen can vary on post contrast scans depending on the phase of image acquisition [27] . The attenuation value of normal liver on unenhanced CT ranges between 55 and 65 Hounsfield units (HU) and is generally at least 8 HU higher relative to the spleen; the liver is regarded as fatty when the liver attenuation is at least 10 HU less than the spleen [59] .…”

Section: Hepatic Parenchymamentioning

confidence: 99%

“…However, these sequences are seldom used for hepatic fat evaluation due to their poor sensitivity. Detection and quantification of fatty liver is much better performed with chemical shift imaging or MR proton spectroscopy [27] . Chemical shift imaging utilizes the differences of resonance frequencies between water and fat proton signals to quantify fat accumulation.…”

Section: Hepatic Parenchymamentioning

confidence: 99%

“…A graft that is too small has increased likelihood of dysfunction secondary to inadequate functional hepatic mass and possible excessive portal perfusion [73] . A small for size graft is also prone to torsion and may necessitate additional surgical maneuvers like fixation of falciform ligament to anterior aspect of the peritoneal cavity [27] . For volumetric analysis, any cross-sectional imaging that provides sufficient contrast between the liver parenchyma and the surrounding tissues can be used.…”

Section: Liver Volumementioning

confidence: 99%

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Expectations from imaging for pre-transplant evaluation of living donor liver transplantation

Hennedige

Gopinathan

Madhavan

2014

WJR

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Core tip: Living donor liver transplantation (LDLT) has evolved to a widely accepted therapeutic option. As a radiologist, knowledge of the various anatomical variations and pathological states in both the donor and recipient are imperative to generating a meaningful report in pre-operative evaluation. This paper provides a brief overview of the common surgical concepts of LDLT and gives a detailed description of the minimum that a radiologist is expected to seek and report in computed tomography and magnetic resonance scans performed for LDLT related evaluation.

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Section: Hepatic Arterial Systemmentioning

confidence: 99%

Section: Hepatic Parenchymamentioning

confidence: 99%

Section: Hepatic Parenchymamentioning

confidence: 99%

Section: Liver Volumementioning

confidence: 99%

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Expectations from imaging for pre-transplant evaluation of living donor liver transplantation

Hennedige

Gopinathan

Madhavan

2014

WJR

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“…During the last few years, computer-aided surgical planning systems (CAD) have contributed significantly in diagnosing and treatment of liver diseases [3]. These cutting-edge methods portray the structure of liver and its vessels often in the form of 3D visualizations, provide insights into surgical simulations with cutting guidelines.…”

Section: Introductionmentioning

confidence: 99%

A Modified Distance Regularized Level Set Model for Liver Segmentation from CT Images

Altarawneh¹,

Luo²,

Regan³

et al. 2015

SIPIJ

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Segmentation of organs from medical images is an active and interesting area of research. Liver segmentation incurs more challenges and difficulties compared with segmentation of other organs. In this paper we demonstrate a liver segmentation method for computer tomography images. We revisit the distance regularization level set (DRLS) model by deploying new balloon forces. These forces control the direction of the evolution and slow down the evolution process in regions that are associated with weak or without edges. The newly added balloon forces discourage the evolving contour from exceeding the liver boundary or leaking at a region that is associated with a weak edge, or does not have an edge. Our experimental results confirm that the method yields a satisfactory overall segmentation outcome.Comparing with the original DRLS model, our model is proven to be more effective in handling oversegmentation problems.

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Angiography with cone‐beam CT versus contrast‐enhanced MRI for living donor transplant imaging: Is MRI enough?

Ali,

Weinstein,

Sarwar

et al. 2023

Clinical Anatomy

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The purpose of this study is to compare the subjective and objective quality and confidence between conventional angiography with cone‐beam computed tomography (CBCT) and magnetic resonance imaging (MRI) for the preoperative evaluation of potential donors for living donor liver transplant. Seventeen patients undergoing preoperative donor evaluation for living donor liver transplantation that underwent angiography with CBCT and contrast‐enhanced MRI for evaluation of hepatic vascular anatomy were included in the study. Four attending radiologists interpreted anonymized, randomized angiography with CBCT images and MRIs, rating the diagnostic quality and confidence of their interpretation (on a 3‐point scale) for each element, as well as clinically relevant measurements. Overall, the readers rated the quality of angiography with CBCT to be higher than that of MRI (median [interquartile range] = 3 (2, 3) vs. 2 (1–3), p < 0.001) across all patients. Readers of angiography with CBCT had more confidence in their interpretations as an average of all elements evaluated than the MRI readers (3 (3) vs. 3 (2, 3), p < 0.001). When the same reader interpreted both MRI and CBCT, the right hepatic artery diameter (3.8 mm ± 0.72 mm vs. 4.5 mm ± 1.2 mm, p < 0.005) and proper hepatic artery diameter (4.43 mm ± 0.98 mm vs. 5.4 mm ± 1.05 mm, p < 0.003) were significantly different between MRI and CBCT. There was poor interrater reliability for determining segment IV arterial supply for both modalities (κ < 0.2). Angiography with CBCT provides higher subjective diagnostic quality and greater radiologist confidence than MRI. The difference in measurements between CBCT and MRI when the same reader reads both studies suggests CBCT adds additional information over MRI evaluation alone.

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Preoperative liver donor evaluation: Imaging and pitfalls

Cited by 49 publications

References 39 publications

Expectations from imaging for pre-transplant evaluation of living donor liver transplantation

Expectations from imaging for pre-transplant evaluation of living donor liver transplantation

A Modified Distance Regularized Level Set Model for Liver Segmentation from CT Images

Angiography with cone‐beam CT versus contrast‐enhanced MRI for living donor transplant imaging: Is MRI enough?

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