Catucci, Damiano Livio Aldo; Hrycyk, Joris; Lange, Naomi Franziska; Obmann, Verena Carola; Berzigotti, Annalisa; Ebner, Lukas; Christe, Andreas; Heverhagen, Johannes; Huber, Adrian Thomas (29 February 2024). Noninvasive assessment of liver segmental volumes and its relationship with 5-year prognostication (Unpublished). In: European Congress of Radiology. Vienna, Austria. 28.02.2024-03.03.2024.
Purpose or Learning Objective
This study aimed to analyse the performance of caudate to right lobe ratio (CRL-R), liver segmental volume ratio (LSVR) and liver segmental volume and attenuation ratio (LSVAR) to screen for chronic liver disease (CLD) on routine abdominal CT scans and to predict the 5-year probability of transplant-free survival and first hepatic decompensation.
Methods or Background
This retrospective study included 108 patients without CLD (noCLD-group; n=108), as well as 98 patients with CLD and liver biopsy. All patients underwent abdominal CT scans between 03/2015 and 08/2017. Patients with CLD were further divided into three groups based on their liver fibrosis degree: early CLD (F0-F2; eCLD-group; n=40), advanced CLD (F3-F4; aCLD-group; n=20), and aCLD with clinically significant portal hypertension according to the BAVENO VII consensus (aCLDPH-group; n=38). CRL-R, LSVR, and LSVAR were measured in all patients. The study analysed the 5-year outcomes of each patient, including death or liver transplantation and first hepatic decompensation. Statistical analysis included the Kruskal-Wallis test, ROC curve analysis, and the Kaplan-Meier curve.
Results or Findings
CRL-R, LSVR and LSVAR differed significantly between all groups (p<0.001). A CRL-R cutoff-value of > 0.93 proofed best to detect patients with CLD (sensitivity of 69%, specificity of 78%). Patients with both CRL-R >0.99 and LSVR >0.37 had the lowest probability of 5-year transplant-free survival (46%) and the lowest probability of a decompensation-free 5-year course (75%).
Conclusion
CRL-R, LSVR and LSVAR allow screening for CLD and prognostication of 5-year transplant-free survival and occurrence of first hepatic decompensation.
Limitations
The limitations of this study were its retrospective design and the lack of invasive measurement of the hepatovenous pressure gradient, which was not available due to ethical concerns.
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