Catucci, Damiano Livio Aldo; Hrycyk, Joris; Lange, Naomi Franziska; Obmann, Verena Carola; Berzigotti, Annalisa; Ebner, Lukas; Heverhagen, Johannes; Christe, Andreas; Huber, Adrian Thomas (20 June 2024). Noninvasive assessment of liver segmental volumes and its relationship with 5-year prognostication (Unpublished). In: Swiss Congress of Radiology. Geneva, Switzerland. 20.06.2024-22.06.2024.
Purpose:
This study aimed to analyze the predictive value of liver segmental volume and attenuation ratio (LSVR / LSVAR), and caudate to right lobe ratio (CRL-R) 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 and Materials:
This retrospective study included 108 patients without CLD (noCLD-group; n=108), as well as 98 patients with biopsy-proven CLD. All patients underwent abdominal CT scans between 03/2015 and 08/2017. Patients with CLD were divided into three groups: early CLD (F0-F2; eCLD; n=40), advanced CLD (F3-F4; aCLD; n=20), and aCLD with clinically significant portal hypertension according to the BAVENO VII consensus (aCLDPH; n=38). CRL-R, LSVR, and LSVAR were compared between groups using Kruskal-Wallis test and ROC analysis was used to determine cutoff-values. 5-year transplant-free survival and first hepatic decompensation were assessed by Kaplan-Meier curve analysis.
Results:
CRL-R, LSVR and LSVAR differed significantly between all groups (p<0.001). A CRL-R cutoff-value of >0.93 predicted aCLD with a sensitivity of 69% and a specificity of 78%, while LSVR >0.37 had a sensitivity of 68% and a specificity of 80%. 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%). In comparison, patients with both CRL-R <0.99 and LSVR <0.37 showed a higher probability of 5-year transplant-free survival (86%) and a higher probability of a decompensation-free 5-year course (98%).
Conclusion:
LSVR, LSVAR and CRL-R, measured on routine abdominal CT scans, show a high predictive value for CLD and 5-year outcome prognostication and are helpful in detecting chronic liver disease and predicting liver disease progression.
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