Liver volumetry in cirrhotic patients with or without hepatocellular carcinoma: Its correlation with Child-Pugh, model for end-stage liver diseases and indocyanine green dye test

Yashwant Patidar; Kartik Mittal; Ranjan Kumar Patel; Sherin Sarah Thomas; Shiv Kumar Sarin

doi:10.1007/s12664-023-01490-1

Liver volumetry in cirrhotic patients with or without hepatocellular carcinoma: Its correlation with Child-Pugh, model for end-stage liver diseases and indocyanine green dye test

Indian J Gastroenterol. 2024 Feb 13. doi: 10.1007/s12664-023-01490-1. Online ahead of print.

Authors

Yashwant Patidar¹, Kartik Mittal², Ranjan Kumar Patel³, Sherin Sarah Thomas⁴, Shiv Kumar Sarin⁵

Affiliations

¹ Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110 070, India. dryashwantpatidar@gmail.com.
² Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110 070, India.
³ Department of Radiodiagnosis, All India Institute of Medical Sciences, Patrapada, Bhubaneswar, 751 019, India.
⁴ Department of Biochemistry, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi, 110 070, India.
⁵ Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, 110 070, India.

PMID: 38349461
DOI: 10.1007/s12664-023-01490-1

Abstract

Background and objectives: To evaluate the correlation between non-tumoral liver volume (NTLV) by computed tomography (CT) volumetry and indocyanine green retention at 15 minutes (ICG-r15%), Child-Pugh score (CTP) and model for end-stage liver diseases (MELD) score in cirrhotic patients having hepatocellular carcinoma (HCC) (group A) and in cirrhotics without HCC (group B).

Methods: As many as 111 consecutive patients with liver cirrhosis, who underwent triple-phase CT abdomen, were retrospectively included in our study. They were classified into group A (cirrhosis with HCC, n = 69) and group B (cirrhosis only, n = 42). Segmental liver volume, tumor and NTLV were calculated using Myrian XP-Liver segmentation software. In group B, NTLV was the same as the total liver volume (TLV). The correlation of NTLV with ICG-r15%, CTP and MELD scores was analyzed using appropriate correlation tests for each group.

Results: NTLV had a good and significant negative correlation with ICG-r15% (ρ = - 512; p < 0.001) in group A, but not in group B. It also had a significant negative correlation with CTP (ρ = - 251; p = 0.038) and MELD (ρ = - 323; p = 0.007) scores only in group A. Furthermore, ICG-r15% had a good and significant positive correlation with CTP and MELD scores in both groups (p < 0.05).

Conclusion: NTLV showed a significant negative correlation with ICG-r15% in cirrhotic patients with HCC, but not in cirrhotic patients without HCC. Therefore, CT volumetry can be a valuable tool to predict the functional hepatic volume in patients of cirrhosis with HCC subjected for hepatectomy, where a facility of ICG-r15% is not available. However, further studies are needed to validate our findings in cirrhotic only patients.

Keywords: CT volumetry; Child–Pugh score (CTP); Cirrhosis; Hepatic functional reserve; Hepatocellular carcinoma; Indocyanine green; Model for End-stage Liver Diseases.