Hepatic Height on Coronal Computed Tomography Images Predicts Total Liver Volume in European Adults Without Liver Disease

Background and objectivesWe assessed safety and efficacy of another somatostatin receptor analog, pasireotide long-acting release, in severe polycystic liver disease and autosomal dominant polycystic kidney disease. Pasireotide long-acting release, with its broader binding profile and higher affinity to known somatostatin receptors, has potential for greater efficacy.Design, setting, participants, & measurementsIndividuals with severe polycystic liver disease were assigned in a 2:1 ratio in a 1-year, double-blind, randomized trial to receive pasireotide long-acting release or placebo. Primary outcome was change in total liver volume; secondary outcomes were change in total kidney volume, eGFR, and quality of life.ResultsOf 48 subjects randomized, 41 completed total liver volume measurements (n=29 pasireotide long-acting release and n=12 placebo). From baseline, there were −99±189 ml/m absolute and −3%±7% change in annualized change in height-adjusted total liver volume (from 2582±1381 to 2479±1317 ml/m) in the pasireotide long-acting release group compared with 136±117 ml/m absolute and 6%±7% increase (from 2387±759 to 2533±770 ml/m) in placebo (P<0.001 for both). Total kidney volumes decreased by −12±34 ml/m and −1%±4% in pasireotide long-acting release compared with 21±21 ml/m and 4%±5% increase in the placebo group (P=0.05 for both). Changes in eGFR were similar between groups. Among the n=48 randomized, adverse events included hyperglycemia (26 of 33 [79%] in pasireotide long-acting release versus four of 15 [27%] in the placebo group; P<0.001), and among the 47 without diabetes at baseline, 19 of 32 (59%) in the pasireotide long-acting release group versus one of 15 (7%) in the placebo group developed diabetes (P=0.001).ConclusionsAnother somatostatin analog, pasireotide long-acting release, slowed progressive increase in both total liver volume/total kidney volume growth rates without affecting GFR decline. Participants experienced higher frequency of adverse events (hyperglycemia and diabetes).Clinical Trial registry name and registration numberPasireotide LAR in Severe Polycystic Liver Disease, NCT01670110PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_08_28_CJN13661119.mp3

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Utilization of Distilled Water Lavage for Localized Fluid Collection After Combined Hepatectomy and Cyst Fenestration for Polycystic Liver Disease

International Surgery ◽

10.9738/intsurg-d-16-00254.1 ◽

2016 ◽

Vol 101 (11-12) ◽

pp. 535-541

Author(s):

Kazuya Yamaguchi ◽

Daisuke Morioka ◽

Atsuo Kobayashi ◽

Nobutoshi Horii ◽

Kentaro Miyake ◽

...

Keyword(s):

Liver Disease ◽

Fluid Collection ◽

Liver Volume ◽

Distilled Water ◽

Polycystic Liver Disease ◽

Total Liver Volume ◽

Total Liver ◽

Polycystic Liver ◽

Abdominal Fullness ◽

Cyst Fenestration

Ascites necessitating persistent drainage or paracentesis after drain removal has been found among early postoperative complications after combined hepatectomy and cyst fenestration (CHCF) for polycystic liver disease (PLD). It has been reportedly observed in 20% to 70% of cases and seemed to easily cause recurrent symptoms unless properly treated. We utilized distilled water lavage for treating localized fluid collection after combined hepatectomy and cyst fenestration for PLD. A 63-year-old female patient underwent CHCF for PLD, which caused severe abdominal fullness. Early postoperative course was uneventful until 10 days after surgery when the patient suffered sudden abdominal fullness and resultant severe anorexia because of right subphrenic massive localized monolocular fluid collection diagnosed by abdominal computed tomography—although total liver volume was reduced to less than half of that before surgery. Percutaneous drainage relieved symptoms immediately, but the drainage tube could not be removed because of massive outflow. Then we utilized distilled water lavage for treating this condition. After that, drain outflow dramatically reduced and the drainage tube was successfully removed. Total liver volume of the patient continued to reduce up to 1 year after surgery and retained less than one-third of preoperative total liver volume thereafter. Sustained reduction of total liver volume in the present case suggested a sclerosant effect of hypotonic cytocidal property of distilled water for cyst endothelium and/or retrieved effectiveness of fenestration. Hence, we consider this approach to be useful for patients with PLD receiving CHCF and thus present it here.

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Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases

European Radiology ◽

10.1007/s00330-008-0996-8 ◽

2008 ◽

Vol 18 (10) ◽

pp. 2345-2354 ◽

Cited By ~ 54

Author(s):

Martijn R. Meijerink ◽

Jan Hein T. M. van Waesberghe ◽

Lineke van der Weide ◽

Petrousjka van den Tol ◽

Sybren Meijer ◽

...

Keyword(s):

Liver Metastases ◽

Image Fusion ◽

Liver Volume ◽

Perfusion Ct ◽

Total Liver Volume ◽

Total Liver

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Predicting Role of Dosimetric Parameters for Nonclassic Radiation-Induced Liver Disease After Helical Tomotherapy in Child-Pugh Class a Primary Liver Carcinoma Patients

10.21203/rs.3.rs-123437/v1 ◽

2020 ◽

Author(s):

Boyan Wang ◽

Jianying Zhang ◽

Zhaochong Zeng

Keyword(s):

Liver Disease ◽

Helical Tomotherapy ◽

Liver Volume ◽

Liver Carcinoma ◽

Total Liver Volume ◽

Primary Liver Carcinoma ◽

Class A ◽

Radiation Induced ◽

The Mean

Abstract PurposeThis study sought to analyze the predicting role of dosimetric parameters for nonclassic radiation-induced liver disease (RILD) after helical tomotherapy (HT) in Child-Pugh (CP) class A primary liver carcinoma (PLC) patients.Patients and methodsA total number of 71 CP class A PLC patients treated with HT from June 2011 to June 2015 were retrospectively reviewed. Clinical characteristics and dose-volume histogram (DVH) were recorded, and liver functions were followed up for 4 months after radiotherapy.ResultsIn all, 57 patients (80.3%) were male, and 14 (19.7%) were female, with a median age of 53 years. The mean gross tumor volume (GTV) was 226.8 cm3. A median dose of 55.0 Gy was delivered by HT with a median fraction size of 2.6 Gy. Twelve patients (16.9%) were diagnosed with nonclassic RILD. The mean dose to normal liver (MDTNL) and the percentage of total liver volume receiving more than 25 - 35 Gy irradiations (V25 - V35) were related to nonclassic RILD. MDTNL showed the highest AUC (0.705, p=0.026). The optimal cut-off value of MDTNL was 21.3 Gy with a sensitivity, specificity and accuracy of 83.3%, 62.7% and 67.6%, respectively. The tolerable volume percentages for DVH were less than: V25 of 42.3%, V30 of 33.9%, and V35 of 28.3%.ConclusionThis study suggests that MDTNL, V25, V30 and V35 are dosimetric predictors for nonclassic RILD in CP class A PLC patients. MDTNL < 21.3Gy, V25 < 42.3%, V30 < 33.9%, and V35 < 28.3% may be used to optimize HT planning.

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Prognostic Factors for Overall Survival in Advanced Intrahepatic Cholangiocarcinoma Treated with Yttrium-90 Radioembolization

Journal of Clinical Medicine ◽

10.3390/jcm9010056 ◽

2019 ◽

Vol 9 (1) ◽

pp. 56 ◽

Cited By ~ 3

Author(s):

Michael Köhler ◽

Fabian Harders ◽

Fabian Lohöfer ◽

Philipp M. Paprottka ◽

Benedikt M. Schaarschmidt ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Liver Disease ◽

Surgical Resection ◽

Intrahepatic Cholangiocarcinoma ◽

Tumor Volume ◽

Cox Regression ◽

Tertiary Care ◽

Liver Volume ◽

Total Liver Volume

Purpose: To evaluate factors associated with survival following transarterial 90Y (yttrium) radioembolization (TARE) in patients with advanced intrahepatic cholangiocarcinoma (ICC). Methods: This retrospective multicenter study analyzed the outcome of three tertiary care cancer centers in patients with advanced ICC following resin microsphere TARE. Patients were included either after failed previous anticancer therapy, including relapse after surgical resection, or for having a minimum of 25% of total liver volume affected by ICC. Patients were stratified and response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria at 3 months. Kaplan–Meier analysis was performed to analyze survival followed by cox regression to determine independent prognostic factors for survival. Results: 46 patients were included (19 male, 27 female), median age 62.5 years (range 29–88 years). A total of 65% of patients had undergone previous therapy, while 63% had a tumor volume > 25% of the entire liver volume. Median survival was 9.5 months (95% CI: 6.1–12.9 months). Due to loss in follow-up, n = 37 patients were included in the survival analysis. Cox regression revealed the extent of liver disease to one or both liver lobes being associated with survival, irrespective of tumor volume (p = 0.041). Patients with previous surgical resection of ICC had significantly decreased survival (3.9 vs. 12.8 months, p = 0.002). No case of radiation-induced liver disease was observed. Discussion: Survival after 90Y TARE in patients with advanced ICC primarily depends on disease extent. Only limited prognostic factors are associated with a general poor overall survival.

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Management of cystic liver disease

10.1093/med/9780199592548.003.0311_update_001 ◽

2018 ◽

Author(s):

René M. M. van Aerts ◽

Tom J. G. Gevers ◽

Joost P. H. Drenth

Keyword(s):

Liver Disease ◽

Liver Volume ◽

Somatostatin Analogues ◽

Polycystic Liver Disease ◽

Total Liver Volume ◽

Liver Cysts ◽

Polycystic Liver ◽

Exogenous Oestrogen ◽

Autosomal Dominant Polycystic Kidney ◽

Cystic Liver

In a subset of autosomal dominant polycystic kidney disease patients, hepatic cysts dominate the clinical picture. These patients may develop polycystic liver disease, and enlargement of the liver leads to compression of adjacent abdominal and thoracic organs. The main risk factors for growth of liver cysts are female sex, exogenous oestrogen use, multiple pregnancies, and severity of renal disease. Treatment is only indicated in those with symptoms, and choice of treatment depends on total liver volume, size, and location of the liver cysts. Current radiological and surgical therapies include aspiration-sclerotherapy, fenestration, segmental hepatic resection, and liver transplantation. They all are palliative in nature and are partially effective and have non-negligible morbidity and mortality. Somatostatin analogues are still in development for polycystic liver disease.

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Accuracy of estimated total liver volume formulas before liver resection

Surgery ◽

10.1016/j.surg.2019.05.003 ◽

2019 ◽

Vol 166 (3) ◽

pp. 247-253 ◽

Cited By ~ 4

Author(s):

Pim B. Olthof ◽

Ronald van Dam ◽

Elio Jovine ◽

Ricardo Robles Campos ◽

Eduardo de Santibañes ◽

...

Keyword(s):

Liver Resection ◽

Liver Volume ◽

Total Liver Volume ◽

Total Liver

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Body surface area and body weight predict total liver volume in Western adults

Liver Transplantation ◽

10.1053/jlts.2002.31654 ◽

2002 ◽

Vol 8 (3) ◽

pp. 233-240 ◽

Cited By ~ 359

Author(s):

J Vauthey

Keyword(s):

Body Weight ◽

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Liver Volume ◽

Total Liver Volume ◽

Total Liver

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Noninvasive Quantification of Hepatic Steatosis: Relationship Between Obesity Status and Liver Fat Content

The Open Obesity Journal ◽

10.2174/1876823701406010016 ◽

2014 ◽

Vol 6 (1) ◽

pp. 16-24 ◽

Cited By ~ 3

Author(s):

S. C. McLeay ◽

G. A. Morrish ◽

T. K. Ponnuswamy ◽

B. Devanand ◽

M. Ramanathan ◽

...

Keyword(s):

Fatty Liver ◽

Hepatic Steatosis ◽

Liver Volume ◽

Fat Content ◽

Liver Fat ◽

Normal Body Mass Index ◽

Liver Fat Content ◽

Total Liver Volume ◽

Total Liver ◽

Obese Subjects

The aim of this study was to assess and compare fat content within the liver for normal (body mass index (BMI) < 25 kg/m2), overweight (25-30 kg/m2) and obese (≥ 30 kg/m2) subjects using a noninvasive, non-contrast computed tomography (CT) quantification method. Adult subjects aged 18-60 yrs scheduled to undergo CT examination of the abdominal region were recruited for this study, stratified across BMI categories. Liver volume, fat content, and lean liver volume were determined using CT methods. A total of 100 subjects were recruited, including 30 normal weight, 31 overweight, and 39 obese. Total liver volume increased with BMI, with mean values of 1138 ± 277, 1374 ± 331, and 1766 ± 389 cm3 for the normal, overweight, and obese, respectively (P < 0.001), which was due to an increase in both liver fat content and lean liver volume with BMI. Some obese subjects had no or minimal hepatic fat content. The prevalence of mild fatty liver in this study of 100 subjects was overestimated for all BMI categories using a range of qualitative diagnostic measures, with predicted prevalence of fatty liver in obese subjects ranging from 76.9% for liver-to-spleen ratio ≤ 1.1 to 89.7% for liver attenuation index (liver HU - spleen HU) ≤ 40, compared to 66.7% by quantification of fat content. Results show that total liver volume increases with BMI, however, not all obese subjects display fatty infiltration of the liver. CT quantification of liver fat content may be suitable for accurate diagnosis of hepatic steatosis in clinical practice and assessment of donor livers for transplantation.

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