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Assessment of Liver Volumes Using Semiautomated Segmentation and Development of a Predictive Formula in the Indian
Boney G Joseph1, Bishal Pal1, Souradeep Dutta1
1Department of Surgery, Division of HPB Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Background:
Accurate liver volume (LV) assessment is critical for hepatic surgeries and transplantation. Existing predictive formulas, primarily derived from Western populations, lack applicability to the Indian demographic. This study aimed to establish LV norms and develop a predictive formula for the Indian population using semiautomated segmentation.
Methods:
A prospective observational study was conducted at a tertiary center in India (2021-2023) on 194 adults (108 males and 86 females) without hepatobiliary pathology. These patients underwent contrast-enhanced computed tomography (CT) scans for non-hepatobiliary indications (e.g., trauma evaluation, prospective renal donors, undiagnosed abdominal pain) with strictly confirmed normal liver morphology and function. Total LV (TLV) and segmental volumes were measured using contrast-enhanced CT scans and the semiautomated SyngoVA30 software. Demographic and anthropometric data (age, sex, height, weight, body mass index, and body surface area [BSA]) were analyzed via univariate/multivariate regression to derive a predictive formula.
Results:
Median TLV was 1177.5 ml (interquartile range: 970.25-1380), significantly higher in males (1231.5 ml vs. 1079 ml, P < 0.001). BSA emerged as the sole independent predictor of TLV (regression coefficient: 1053.37, P < 0.001, R2 = 0.50). The derived formula for standard LV (SLV) was: 1053.37 × BSA-434.24 (simplified formula: 1050 ∗ BSA-435), which showed close agreement with measured volumes compared to several existing Asian and Western formulas. Segmental proportions (right lobe: 66.6%, left lobe: 30.5%, and caudate lobe: 2.9%) mirrored Western studies despite lower overall TLV.
Conclusion:
The BSA-based formula may be useful for predicting SLV in Indians, addressing a critical gap in preoperative planning. Regional demographic variations necessitate population-specific models. Further multicenter validation is warranted to enhance generalizability across India.
