Skip to main content
Log in

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

  • Original Article
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

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.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Heidelbaugh JJ, Sherbondy M. Cirrhosis and chronic liver failure: part II. Complications and treatment. Am Fam Physician. 2006;74:767–76.

    PubMed  Google Scholar 

  2. Mahmud N, Fricker Z, Hubbard RA, et al. Risk prediction models for post-operative mortality in patients with cirrhosis. Hepatology. 2021;73:204–18. https://doi.org/10.1002/hep.31558.

    Article  PubMed  Google Scholar 

  3. Rassam F, Olthof PB, Bennink RJ, van Gulik TM. Current modalities for the assessment of future remnant liver function. Visc Med. 2017;33:442–8. https://doi.org/10.1159/000480385.

    Article  PubMed  PubMed Central  Google Scholar 

  4. De Gasperi A, Mazza E, Prosperi M. Indocyanine green kinetics to assess liver function: ready for a clinical dynamic assessment in major liver surgery? World J Hepatol. 2016;8:355–67. https://doi.org/10.4254/wjh.v8.i7.355.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wang YY, Zhao XH, Ma L, et al. Comparison of the ability of Child-Pugh score, MELD score, and ICG-R15 to assess preoperative hepatic functional reserve in patients with hepatocellular carcinoma. J Surg Oncol. 2018;118:440–5. https://doi.org/10.1002/jso.25184.

    Article  CAS  PubMed  Google Scholar 

  6. Tu R, Xia LP, Yu AL, Wu L. Assessment of hepatic functional reserve by cirrhosis grading and liver volume measurement using CT. World J Gastroenterol. 2007;13:3956–61. https://doi.org/10.3748/wjg.v13.i29.3956.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Zhang JW, Feng XY, Liu HQ, et al. CT volume measurement for prognostic evaluation of unresectable hepatocellular carcinoma after TACE. World J Gastroenterol. 2010;16:2038–45. https://doi.org/10.3748/wjg.v16.i16.2038.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Durand F, Valla D. Assessment of the prognosis of cirrhosis: Child-Pugh versus MELD. J Hepatol. 2005;42:S100–7. https://doi.org/10.1016/j.jhep.2004.11.015.

    Article  PubMed  Google Scholar 

  9. Peng Y, Qi X, Guo X. Child-Pugh versus MELD score for the assessment of prognosis in liver cirrhosis: a systematic review and meta-analysis of observational studies. Medicine (Baltimore). 2016;95: e2877. https://doi.org/10.1097/MD.0000000000002877.

  10. Seyama Y, Kokudo N. Assessment of liver function for safe hepatic resection. Hepatol Res. 2009;39:107–16. https://doi.org/10.1111/j.1872-034X.2008.00441.x.

    Article  PubMed  Google Scholar 

  11. Møller S, la Cour SE, Madsen JL, Bendtsen F. Indocyanine green retention test in cirrhosis and portal hypertension: accuracy and relation to severity of disease. J Gastroenterol Hepatol. 2019;34:1093–9. https://doi.org/10.1111/jgh.14470.

    Article  CAS  PubMed  Google Scholar 

  12. Shalimar, Jain S, Gamanagatti SR, et al. Role of indocyanine green in predicting post-transarterial chemoembolization liver failure in hepatocellular carcinoma. J Clin Exp Hepatol. 2018;8:28–34. https://doi.org/10.1016/j.jceh.2017.05.012.

    Article  CAS  PubMed  Google Scholar 

  13. Jeong EM, Hwang SG, Park HH, et al. The anaylsis of mortality rate according to CTP score and MELD score in patients with liver cirrhosis. Korean J Hepatol. 2003;9:98–106.

  14. Lim MC, Tan CH, Cai J, Zheng J, Kow AW. CT volumetry of the liver: where does it stand in clinical practice? Clin Radiol. 2014;69:887–95. https://doi.org/10.1016/j.crad.2013.12.021.

    Article  CAS  PubMed  Google Scholar 

  15. Goumard C, Perdigao F, Cazejust J, Zalinski S, Soubrane O, Scatton O. Is computed tomography volumetric assessment of the liver reliable in patients with cirrhosis? HPB (Oxford). 2014;16:188–94. https://doi.org/10.1111/hpb.12110.

    Article  PubMed  Google Scholar 

  16. Ferrero A, Viganò L, Polastri R, et al. Postoperative liver dysfunction and future remnant liver: where is the limit? Results of a prospective study. World J Surg. 2007;31:1643–51. https://doi.org/10.1007/s00268-007-9123-2.

    Article  PubMed  Google Scholar 

  17. Ozaki K, Matsui O, Kobayashi S, Minami T, Kitao A, Gabata T. Morphometric changes in liver cirrhosis: aetiological differences correlated with progression. Br J Radiol. 2016;89:20150896. https://doi.org/10.1259/bjr.20150896.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Matsumoto Y, Fujii H, Matsuda M, Kono H. Multicentric occurrence of hepatocellular carcinoma: diagnosis and clinical significance. J Hepatobiliary Pancreat Surg. 2001;8:435–40. https://doi.org/10.1007/s005340100006.

    Article  CAS  PubMed  Google Scholar 

  19. Hanna RF, Aguirre DA, Kased N, Emery SC, Peterson MR, Sirlin CB. Cirrhosis-associated hepatocellular nodules: correlation of histopathologic and MR imaging features. Radiographics. 2008;28:747–69. https://doi.org/10.1148/rg.283055108.

    Article  PubMed  Google Scholar 

  20. Elsawy AA, Dawoud MM, Elarabawy RA, Mohamed WS, Dawoud RM. Role of residual liver volumetry and function in prediction of liver tolerability after transarterial chemoembolization for hepatocellular carcinoma in cirrhotic patients: deriving a clinical decision support score. Egypt J Radiol Nucl Med. 2020;51:1–3.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

YP, KM, SKS: conceptualized the study design; YP, KM, RKP, SST: collected the data, analyzed the data; YP, KM, RKP: prepared the manuscript.

Corresponding author

Correspondence to Yashwant Patidar.

Ethics declarations

Conflict of interest

YP, KM, RKP, SST and SKS declare no competing interests.

Ethics statement

The study was performed conforming to the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Disclaimer

The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Patidar, Y., Mittal, K., Patel, R.K. et al. 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). https://doi.org/10.1007/s12664-023-01490-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12664-023-01490-1

Keywords

Navigation