Korean J Transplant.  2022 Nov;36(Supple 1):S150. 10.4285/ATW2022.F-2687.

The role of computed tomography volumetry of the liver with subsequent three-dimensional modeling in the planning of the operation

• Erzhanov Z

• KMID: 2535666
• DOI: http://doi.org/10.4285/ATW2022.F-2687

Abstract

Background
To evaluate the capabilities and reliability of the computed tomography (CT) method with the subsequent construction of three-dimensional (3D) reconstructions and segmentation as a tool for planning surgical intervention in liver ma-lignancies.
Methods
Measurements of the future residual volume of the liver (FRLV) using CT were performed in 39 patients before vari-ous operations, as well as on day 8 after surgery. CT volumetry was performed on a scanner with an 80-row detector with intravenous contrast. Semi-automatic post-processing of the volume of the data obtained consists in algorithmic layer-by-layer calculation of the number of voxels included in the designated contours of the liver, according to averaged density indicators depending on the phase by contrast, with their further summation reflecting the total volume of the organ. Further, the resulting volume of the liver is divided into fractions and segmented according to anatomical landmarks. With a satisfactory condition of liver tissue for the prevention of the development of postoperative acute renal failure, the critical minimum value of FRLV was established at a level of more than 32%–35% of the total initial volume.
Results
In the period from January 2019 to December 2022, in 39 patients with indications for liver resection, the preoperative values of FRLV were up to 34%–39%. Repeated CT to calculate the increase in parenchyma volume was performed on the 8th day after liver resection. According to the calculation results, all patients had a significant increase in FRLV (195.1%).
Conclusions
The presented method is an important tool of an individual approach when planning liver resections in patients with primary and metastatic malignant tumors, which allows us to reliably estimate not only the total and future residual volumes of the liver, but also the volumes of each segment individually.