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Virtual liver resection and volumetric analysis of the future liver remnant using open source image processing
Joost R van der Vorst1, Ronald M van Dam, Rogier S A van Stiphout
1Department of Surgery, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. j.r.van_der_vorst@lumc.nl
World Journal of Surgery
|July 24, 2010
Summary
OsiriX CT volumetry, performed by surgeons, accurately predicts liver resection volume and future liver remnant volume (FLRV). This free, open-source software offers a time-efficient solution for preoperative planning, reducing the risk of postresection liver failure.
Area of Science:
- Medical Imaging
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Postresection liver failure is a risk after extended liver resection due to insufficient future liver remnant volume (FLRV).
- Accurate preoperative FLRV assessment is critical to mitigate this risk.
- OsiriX PAC is a free, open-source software for liver volume calculation by nonradiologists.
Purpose of the Study:
- To evaluate the accuracy of OsiriX CT volumetry for predicting liver resection volume and FLRV.
- To assess the time efficiency and interobserver variability of OsiriX volumetry.
Main Methods:
- Preoperative contrast-enhanced liver CT scans from 25 partial hepatectomy patients were analyzed.
- Two surgical trainees used OsiriX for liver, resection, and tumor volume measurements.
- A radiologist used Aquarius iNtuition software for comparison.
- Resection volume was correlated with resection weight; interobserver variability was assessed using Bland-Altman plots.
Main Results:
- Significant correlation between resected specimen weight and volume (R(2) = 0.95).
- No major differences in liver, resection, or tumor volumes among observers.
- Small interobserver variability observed via Bland-Altman plots.
- Mean OsiriX liver volumetry time was 19 ± 3 minutes per patient.
Conclusions:
- OsiriX liver volumetry by surgeons is accurate for predicting resection volume and FLRV.
- The method is time-efficient, making it suitable for preoperative planning.
- OsiriX provides a reliable tool to reduce the risk of postresection liver failure.
