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Computed tomography-based measurements of normative liver and spleen volumes in children
Vinicius de Padua V Alves1, Jonathan R Dillman1,2, Elanchezhian Somasundaram1
1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Kasota Building MLC 5031, Cincinnati, OH, 45229, USA.
Insights
This study establishes normal liver and spleen volume reference ranges for children using CT scans. These findings aid in diagnosing organ size abnormalities and potential diseases in pediatric patients.
Area of Science:
- Pediatric Radiology
- Medical Imaging Analysis
- Quantitative Anatomy
Background:
- Organ volumetry is crucial for clinical diagnostics, prognostics, and surgical planning.
- Limited reference values exist for liver and spleen volumes in healthy children.
- Accurate organ size quantification aids in detecting abnormalities and disease progression.
Purpose of the Study:
- To establish reference liver and spleen volumes in a pediatric population.
- To define normal value thresholds for pediatric organ sizes using CT imaging.
- To provide data for identifying potential liver and spleen diseases in children.
Main Methods:
- Retrospective analysis of contrast-enhanced CT scans from 320 children and adolescents.
- Manual segmentation of liver and spleen volumes from CT images.
- Generation of reference intervals using quantile regression models based on age and weight.
- Assessment of agreement based on image slice thickness and inter-reader variability.
Main Results:
- Established reference ranges for liver (340-2002 mL) and spleen (28-480 mL) volumes in children.
- Identified patient weight, age, and sex as independent predictors of liver and spleen volumes.
- Demonstrated excellent agreement (ICC=0.99) in organ volume measurements across different slice thicknesses.
Conclusions:
- Provides essential reference liver and spleen volumes for healthy children.
- Enables identification of organ size abnormalities indicative of disease in pediatric patients.
- Supports improved diagnostic accuracy and clinical management in pediatric radiology.
Background:
Quantification of organ size has utility in clinical care and research for diagnostics, prognostics and surgical planning. Volumetry is regarded as the best measure of organ size and change in size over time. Scarce reference values exist for liver and spleen volumes in healthy children.
Objective:
To report liver and spleen volumes for a sample of children defined by manual segmentation of contrast-enhanced CT images with the goal of defining normal values and thresholds that might indicate disease.
Materials And Methods:
This retrospective study included clinically acquired contrast-enhanced CTs of the abdomen/pelvis for children and adolescents imaged between January 2018 and July 2021. Liver and spleen volumes were derived through manual segmentation of CTs reconstructed at 2.5-, 3- or 5-mm slice thickness. A subset of images (5%, n=16) was also segmented using 0.5-mm slice thickness reconstructions to define agreement based on image slice thickness. We used Pearson correlation and multivariable regression to assess associations between organ volumes and patient characteristics. We generated reference intervals for the 5th, 25th, 50th (median), 75th and 95th percentiles for organ volumes as a function of age and weight using quantile regression models. Finally, we calculated Bland-Altman plots and intraclass correlation coefficients (ICC) to quantify agreement.
Results:
We included a total of 320 children (mean age ± standard deviation [SD] = 9±4.6 years; mean weight 38.1±18.8 kg; 160 female). Liver volume ranged from 340-2,002 mL, and spleen volume ranged from 28-480 mL. Patient weight (kg) (β=12.5), age (months) (β=1.7) and sex (female) (β = -35.3) were independent predictors of liver volume, whereas patient weight (kg) (β=2.4) and age (months) (β=0.3) were independent predictors of spleen volume. There was excellent absolute agreement (ICC=0.99) and minimal absolute difference (4 mL) in organ volumes based on reconstructed slice thickness.
Conclusion:
We report reference liver and spleen volumes for children without liver or spleen disease. These results provide reference ranges and potential thresholds to identify liver and spleen size abnormalities that might reflect disease in children.
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