Standard Liver Volume-Predicting Formulae Derived From Normal Liver Volume in Children Under 18 Years of Age

Area of Science:

• Pediatric surgery
• Medical imaging
• Hepatic oncology

Background:

• Standard liver volume (SLV) is crucial for risk stratification in major hepatectomy procedures.
• Understanding normal liver volume growth patterns in children is essential for accurate pre-operative assessments.
• Existing methods for SLV calculation may not fully account for pediatric-specific growth dynamics.

Purpose of the Study:

• To investigate the age- and body weight-dependent growth patterns of normal liver volume in Chinese children.
• To develop and validate new formulas for calculating SLV in pediatric populations.
• To provide a tool for improved risk assessment in pediatric major hepatectomy.

Main Methods:

• Utilized computed tomography (CT) to measure liver volumes in 792 Chinese children (<18 years) with normal livers.
• Analyzed correlations between liver volume and body weight (BW), body height (BH), and body surface area (BSA).
• Developed and validated new SLV formulas using regression models and multicenter data, considering sex differences above 20 kg BW.

Main Results:

• Liver volume in children grows significantly with age and body weight, from a median of 139 ml at birth to 1180.5 ml at 16-18 years.
• Liver volume showed strong correlations with BW (r=0.95), BH (r=0.92), and BSA (r=0.96).
• Sex-specific SLV formulas were established for children weighing over 20 kg: SLV = 691.90 × BSA^1.06 (males) and SLV = 663.19 × BSA^1.04 (females). A general formula for BW ≤ 20 kg is SLV = 707.12 × BSA^1.09.

Conclusions:

• Established comprehensive growth patterns for liver volume in Chinese children from infancy to adolescence.
• Provided validated, sex-specific formulas for predicting SLV in children, aiding surgical planning.
• These new SLV prediction formulas enhance the safety assessment for major hepatectomies in pediatric patients.