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Quantitative Imaging Features and Postoperative Hepatic Insufficiency: A Multi-Institutional Expanded Cohort.
Linda M Pak1, Jayasree Chakraborty1, Mithat Gonen2
1Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Journal of the American College of Surgeons
|February 18, 2018
Summary
Quantitative imaging features from CT scans can predict post-hepatectomy liver insufficiency (PHLI). These novel imaging biomarkers offer a promising tool for preoperative risk stratification in liver surgery patients.
Area of Science:
- Hepatobiliary surgery
- Radiology
- Oncology
Background:
- Post-hepatectomy liver insufficiency (PHLI) is a major complication following liver resection.
- Quantitative imaging analysis of preoperative CT scans may predict PHLI.
- Previous studies suggest a correlation between future liver remnant (FLR) imaging features and PHLI.
Purpose of the Study:
- To evaluate the utility of quantitative imaging analysis for predicting PHLI.
- To explore the application of quantitative imaging in an expanded, multi-institutional cohort.
- To identify imaging features associated with PHLI risk.
Main Methods:
- Retrospective analysis of 74 PHLI patients and 74 matched controls from 5 academic centers.
- Extraction of quantitative imaging features from FLR on preoperative CT scans.
- Identification of discriminatory features using conditional logistic regression and multivariate analysis.
Main Results:
- Two CT imaging features (FD1_4 and ACM1_10) were significantly associated with PHLI (p=0.018 and p=0.023).
- These imaging features remained significant predictors of PHLI independent of clinical factors like bilirubin and %RLV.
- Colorectal liver metastases, hepatocellular carcinoma, and cholangiocarcinoma were common indications for surgery.
Conclusions:
- Quantitative imaging features are independently associated with PHLI.
- These features serve as a promising preoperative risk stratification tool for liver surgery.
- Further validation in larger cohorts may enhance clinical decision-making.
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