Liver planning software accurately predicts postoperative liver volume and measures early regeneration.
Liver planning software accurately predicts postoperative liver volume and measures early regeneration.
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DOI：
10.1016/j.jamcollsurg.2014.02.027
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发表时间：
2014-08
影响因子：
5.2
通讯作者：
Stefansic, James D.
中科院分区：
文献类型：
--
作者：
Simpson, Amber L.;Geller, David A.;Hemming, Alan W.;Jarnagin, William R.;Clements, Logan W.;D'Angelica, Michael I.;Dumpuri, Prashanth;Goenen, Mithat;Zendejas, Ivan;Miga, Michael I.;Stefansic, James D.
肝切除后的术后或残余肝脏体积（RLV）是围手术期结果的关键预测因素。本研究探讨肝脏手术计划软件预测术后 RLV 和评估早期再生的准确性。 2008 年 6 月至 2010 年期间，我们联系了符合肝切除资格的患者参与这项研究。所有患者在切除前和切除后早期均接受了横断面成像（CT 或 MRI）。使用Scout Liver软件（Pathfinder Therapeutics Inc.，纳什维尔，田纳西州）测量计划残肝体积（pRLV）（基于术前扫描的计划切除）和术后实际残肝体积（aRLV）（根据术后早期扫描确定）。分析 pRLV 和 aRLV 之间的差异，控制术后成像的时间。将测得的 TLV 与计算体积的标准方程进行比较。 2008 年 6 月至 2010 年 6 月期间，三个治疗中心的 66 名患者参加了这项研究。 pRLV 和 aRLV 之间存在相关性（r=0.941，p<0.001），当考虑术后成像时机时，这种相关性得到改善（r=0.953，p<0.001）。根据术后成像时间从 pRLV 到 aRLV 分层病例的相对体积偏差显示，术后五天开始可测量再生，并在八天稳定（p < 0.01）。对于肝脏体积处于上限和下限的患者，使用标准方程很难估计 TLV（在某些情况下高达 50%）。术前对未来肝脏残骸的虚拟规划可以准确预测肝切除术后的体积。术后早期肝脏再生可通过术后五天开始的影像学测量。直接通过 CT 扫描测量 TLV，而不是根据方程计算，会导致 TLV 出现极端情况。
Postoperative or remnant liver volume (RLV) following hepatic resection is a critical predictor of perioperative outcome. This study investigates whether the accuracy of liver surgical planning software for predicting postoperative RLV and assessing early regeneration. Patients eligible for hepatic resection were approached for participation in the study from June 2008 to 2010. All patients underwent cross-sectional imaging (CT or MRI) prior to and early after resection. Planned remnant liver volume (pRLV) (based on the planned resection on the preoperative scan), and postoperative actual remnant liver volume (aRLV) (determined from early postoperative scan) were measured using Scout Liver software (Pathfinder Therapeutics Inc., Nashville, TN). Differences between pRLV and aRLV were analyzed controlling for timing of postoperative imaging. Measured TLV was compared against standard equations for calculating volume. Sixty-six patients were enrolled in the study from June 2008 to June 2010 at three treatment centers. Correlation was found between pRLV and aRLV (r=0.941, p<0.001), which improved when timing of postoperative imaging was considered (r=0.953, p<0.001). Relative volume deviation from pRLV to aRLV stratified cases according to timing of postoperative imaging showed evidence of measurable regeneration beginning five days after surgery with stabilization at eight days (p < 0.01). For patients at the upper and lower extremes of liver volumes, TLV was poorly estimated using standard equations (up to 50% in some cases). Preoperative virtual planning of future liver remnant accurately predicts postoperative volume following hepatic resection. Early postoperative liver regeneration is measureable on imaging beginning at five days following surgery. Measuring TLV directly from CT scans rather than calculating based on equations accounts for extremes in TLV.
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影响因子：
3.8
作者：
ALYASSIN, AM;LANCASTER, JL;FOX, PT
通讯作者：
FOX, PT
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作者：
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通讯作者：
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