Virtual Liver Resection and Volumetric Analysis of the Future Liver Remnant using Open Source Image Processing Software
Virtual Liver Resection and Volumetric Analysis of the Future Liver Remnant using Open Source Image Processing Software
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DOI：
10.1007/s00268-010-0663-5
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发表时间：
2010-10-01
影响因子：
2.6
通讯作者：
Dejong, Cornelis H. C.
中科院分区：
文献类型：
--
作者：
van der Vorst, Joost R.;van Dam, Ronald M.;Dejong, Cornelis H. C.
背景：在扩大的肝切除术后，太小的残肝可导致术后肝功能衰竭。为了降低这种风险，术前评估未来的肝脏残余体积（FLRV）是至关重要的。开源的OsiriX（R）PAC软件系统可以免费下载，非放射科医生可以使用独立的苹果电脑计算肝脏体积。本研究的目的是评估OsiriX（R）CT容积测量法预测肝部分切除术患者的肝切除体积和FLVR的准确性。两名外科实习生使用OsiriX（R）测量总肝脏体积、切除体积和肿瘤体积，放射科医生使用CT扫描仪连接的Aquarius iNtuition（R）软件测量这些体积。切除体积与前瞻性确定的切除重量相关，并分析了测量的肝脏体积的差异。结果25例患者（男/女比：13/12），中位年龄为61岁（范围：34-77）。切除标本的重量和体积之间存在显著相关性（Pearson相关系数：R-2 = 0.95）。观察者1、2和3的总肝脏体积、切除体积或肿瘤体积无重大差异。Bland-Altman图显示观察者间变异性较小。1例患者使用OsiriX（R）完成肝脏体积测定的平均时间为19 +/- 3 min。结论外科医生进行的OsiriX肝脏体积测定是预测切除体积和FLRV的准确且省时的方法。
Background After extended liver resection, a remnant liver that is too small can lead to postresection liver failure. To reduce this risk, preoperative evaluation of the future liver remnant volume (FLRV) is critical. The open-source OsiriX (R) PAC software system can be downloaded for free and used by nonradiologists to calculate liver volume using a stand-alone Apple computer. The purpose of this study was to assess the accuracy of OsiriX (R) CT volumetry for predicting liver resection volume and FLVR in patients undergoing partial hepatectomy.Methods Preoperative contrast-enhanced liver CT scans of patients who underwent partial hepatectomy were analyzed by three observers. Two surgical trainees measured the total liver volume, resection volume, and tumor volume using OsiriX (R), and a radiologist measured these volumes using CT scanner-linked Aquarius iNtuition (R) sbftware. Resection volume was correlated with prospectively determined resection weight, and differences in the measured liver volumes were analyzed. Interobserver variability was assessed using Bland-Altman plots.Results 25 patients (M/F ratio: 13/12) with a median age of 61 (range, 34-77) years were included. There were significant correlations between the weight and volume of the resected specimens (Pearson's correlation coefficient: R-2 = 0.95). There were no major differences in total liver volumes, resection volumes, or tumor volumes for observers 1, 2, and 3. Bland-Altman plots showed a small interobserver variability. The mean time to complete liver volumetry for one patient using OsiriX (R) was 19 +/- 3 min.Conclusions OsiriX liver volumetry performed by surgeons is an accurate and time-efficient method for predicting resection volume and FLRV.