Variability of standard liver volume estimation versus software-assisted total liver volume measurement

Abstract

The estimation of the standard liver volume (SLV) is an important component of the evaluation of potential living liver donors and the surgical planning for resection for tumors. At least 16 different formulas for estimating SLV have been published in the worldwide literature. More recently, several proprietary software-assisted image postprocessing (SAIP) programs have been developed to provide accurate volume measurements based on the actual anatomy of a specific patient. Using SAIP, we measured SLV in 375 healthy potential liver donors and compared the results to SLV values that were estimated with the previously published formulas and each donor's demographic and anthropomorphic data. The percentage errors of the 16 SLV formulas versus SAIP varied by more than 59% (from À21.6% to þ37.7%). One formula was not statistically different from SAIP with respect to the percentage error (À1.2%), and another formula was not statistically different with respect to the absolute liver volume (18 mL). More than 75% of the estimated SLV values produced by these 2 formulas had percentage errors within 615%, and the formulas provided good predictions within acceptable agreement (615%) on scatter plots. Because of the wide variability, care must be taken when a formula is being chosen for estimating SLV, but the 2 aforementioned formulas provided the most accurate results with our patient demographics.

Evaluation of Computer-Assisted Quantitative Volumetric Analysis for Pre-Operative Resectability Assessment of Huge Hepatocellular Carcinoma

“…At present, estimation of the standard liver volume (SLV) is the more widely applied method in clinical practice (Pomposelli et al, 2012;Tong et al, 2012). SLV and body surface area (BSA) can be calculated by a formula according to the height and weight of the patient.…”

“…Many studies have demonstrated that hepatic functional reserve is significantly correlated with liver volume. At least 16 different formulas for estimating the standard liver volume (SLV) have been published worldwide (Pomposelli et al, 2012;Tong et al, 2012). Given the extensive variability, care must be taken when a formula is being chosen for estimating SLV.…”

State of the Art and Future Developments for Surgical Planning in LDLT

“…In our Institution, these images are sent to MEVIS distant service (Bremen, Germany) by an encrypted web transfer protocol for volumetric and anatomic analysis using proprietary FDA-approved software. This technology and the resulting information have been used successfully in the surgical planning of more than 4,500 LDLTs worldwide [1].…”

“…Total and segmental liver volumes are calculated using software-assisted image post-processing (SAIP) which has been proven to be the most accurate method for calculating these volumes, with a reported calculated versus actual volume difference of approximately 17.5 ml and a percentage of error of approximately 2.8 % [1,2]. Since the software calculates the liver volume, which is a combination of liver parenchyma and blood filling the sinusoids, a correction factor of 0.9 is needed to predict the actual liver weight after procurement [3,4].…”

Computed tomography volume measurements of the liver using a liver segmentation and analysis package: an intra- and inter-rater reliability study

“…[13] SAIP tools are increasing in popularity and have been proven to be very accurate in predicting liver volumes. [14,15] Studies have shown that measurement of liver volume using SAIP tools correlate well with manual volumetry, [16] and with the added advantage of being a substantially faster method of volume calculation, [17] they are being touted as the new gold standard for liver volumetry. [18] The purpose of this study was to investigate the intraand inter-rater reliability of a specific SAIP tool, namely, the Philips liver segmentation and analysis package (Eindhoven, The Netherlands).…”