Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR).

Obmann, V. C.; Marx, C.; Hrycyk, J.; Berzigotti, A.; Ebner, L.; Mertineit, N.; Gräni, Ch.; Heverhagen, J. T.; Christe, A.; Huber, A. T. (2021). Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR). Abdominal radiology, 46(5), pp. 1912-1921. Springer 10.1007/s00261-020-02834-7

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BACKGROUND

The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR).

MATERIAL AND METHODS

Patients who underwent portal venous phase abdominal CT scans and MR elastography (reference standard) within 3 months between 02/2016 and 05/2017 were included. The LSVAR was calculated on portal venous CT scans as LSVR*LVCA, while the LSVR represented the volume ratio between Couinaud segments I-III and IV-VIII, and the LVCA represented the density of the liver veins compared to the density in the vena cava. The LSVAR and LSVR were compared between patients with and without significantly elevated liver stiffness (based on a cutoff value of 3.5 kPa) using the Mann-Whitney U test and ROC curve analysis.

RESULTS

The LSVR and LSVAR allowed significant differentiation between patients with (n = 19) and without (n = 122) significantly elevated liver stiffness (p < 0.001). However, the LSVAR showed a higher area under the curve (AUC = 0.96) than the LSVR (AUC = 0.74). The optimal cutoff value was 0.34 for the LSVR, which detected clinically increased liver stiffness with a sensitivity of 53% and a specificity of 88%. With a cutoff value of 0.67 for the LSVAR, the sensitivity increased to 95% while maintaining a specificity of 89%.

CONCLUSION

The LSVAR improves the detection of significant liver fibrosis on portal venous CT scans compared to the LSVR.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Obmann, Verena Carola; Marx, Christina Lynn; Hrycyk, Joris; Berzigotti, Annalisa; Ebner, Lukas; Mertineit, Nando; Gräni, Christoph; Heverhagen, Johannes; Christe, Andreas and Huber, Adrian Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2366-0058

Publisher:

Springer

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

07 Dec 2020 08:19

Last Modified:

21 May 2021 01:31

Publisher DOI:

10.1007/s00261-020-02834-7

PubMed ID:

33156949

Uncontrolled Keywords:

Computed tomography Computer-assisted diagnosis Computer-assisted image processing Fibrosis Liver cirrhosis

BORIS DOI:

10.7892/boris.147876

URI:

https://boris.unibe.ch/id/eprint/147876

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