Development and validation of a comprehensive new hepatobiliary software. Part II: Segmental liver function

Area of Science:

• Nuclear medicine
• Hepatobiliary imaging
• Medical software development

Background:

• Accurate quantification of liver function and size is crucial for surgical planning and disease management.
• Existing methods for assessing lobar and segmental liver function can be variable and lack standardization.

Purpose of the Study:

• To develop and obtain FDA approval for novel hepatobiliary software designed to quantify segmental and lobar liver function.
• To establish a standardized method for assessing liver size and function using 99mTc-HIDA cholescintigraphy.

Main Methods:

• Development of JAVA-based hepatobiliary software compatible with PC and DICOM image data from gamma cameras.
• Automated liver boundary detection and measurement of liver height at the right midclavicular line (RMCL).
• Calculation of geometric mean areas for physiologic lobes and segmental liver function based on 5th-minute 99mTc-HIDA uptake.

Main Results:

• In control participants, mean liver height at RMCL was 14.7 cm, with established geometric mean areas for right lobe (116 cm2), left lobe (96 cm2), and total liver (212 cm2).
• Segmental liver function distribution was quantified: right upper (31%), right lower (34%), left medial (24%), left lateral (10%), and caudate lobe (1%).
• Excellent correlation was observed between CT-defined liver volume and the software's quantitative assessment of liver size and function.

Conclusions:

• The newly FDA-approved software offers a quantitative assessment of segmental, lobar, and total liver size and function from planar 99mTc-HIDA cholescintigraphy.
• This tool has the potential to standardize nuclear hepatology practices universally.
• Quantitative data provided by the software can assist surgeons in determining appropriate tissue resection volumes during liver surgery.