Two-dimensional venogram following portal venous embolization as a predictor for future liver remnant hypertrophy

To determine whether wash-in (WI) and wash-out (WO) rates of contrast involving the future liver remnant (FLR) based on 2-dimensional venograms following portal vein embolization (PVE) can predict liver hypertrophy.

This is a single-center, retrospective, observational, cohort study of consecutive patients who underwent PVE from August 2019 to March 2024 during which the post-PVE venogram was obtained for more than 15 s. Enhancement of the FLR on post-PVE venograms was plotted as a function of time. Piecewise linear fits were applied to the datasets to derive WI and WO rates. Rates were compared to degree of hypertrophy (DH) and kinetic growth rate (KGR).

16 patients who underwent PVE were included in the analysis (RPVE, n = 10; RPVE+4, n = 6). Median standardized FLR (sFLR) prior to PVE increased from 23% (median, range 15-49%) to 34% (median, range 24-54%), P = 0.0008. DH was 11.9% (median, range 2.0-19.9%) and KGR was 2.5% (median, range 0.5-4.7%). WI rates measured 0.0878 (median, range 0.0669-0.1760). WO rates measured 0.0315 (median, range 0.0039-0.0473). WO:WI ratios measured 0.2886 (median, range 0.0538-0.5760). Spearman's rank order correlations were calculated between WO:WI and DH (ρ = 0.6265) as well as WO:WI and KGR (ρ = 0.6529). Multivariate linear regression analysis of WO:WI with DH and KGR yielded P-values of 0.0470 and 0.0980, respectively.

WO:WI ratios of the FLR calculated from 2-dimensional venograms following PVE may correlate with DH, providing immediate post-PVE assessment of the regenerative capacity of the FLR.