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Itoh S, Yoshizumi T, Shirabe K, et al. Functional remnant liver assessment predicts liver-related morbidity after hepatic resection in patients with hepatocellular carcinoma. Hepatol Res. 2016;47(5):398-404doi: 10.1111/hepr.12761.
Itoh, S., Yoshizumi, T., Shirabe, K., Kimura, K., Okabe, H., Harimoto, N., Ikegami, T., Uchiyama, H., Nishie, A., & Maehara, Y. (2017). Functional remnant liver assessment predicts liver-related morbidity after hepatic resection in patients with hepatocellular carcinoma. Hepatology research : the official journal of the Japan Society of Hepatology, 47(5), 398-404. https://doi.org/10.1111/hepr.12761
Itoh, Shinji, et al. "Functional remnant liver assessment predicts liver-related morbidity after hepatic resection in patients with hepatocellular carcinoma." Hepatology research : the official journal of the Japan Society of Hepatology vol. 47,5 (2017): 398-404. doi: https://doi.org/10.1111/hepr.12761
Itoh S, Yoshizumi T, Shirabe K, Kimura K, Okabe H, Harimoto N, Ikegami T, Uchiyama H, Nishie A, Maehara Y. Functional remnant liver assessment predicts liver-related morbidity after hepatic resection in patients with hepatocellular carcinoma. Hepatol Res. 2017 Apr;47(5):398-404. doi: 10.1111/hepr.12761. Epub 2016 Sep 12. PMID: 27283504.
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Hepatol Res. 2017 Apr;47(5):398-404. doi: 10.1111/hepr.12761. Epub 2016 Sep 12.

Functional remnant liver assessment predicts liver-related morbidity after hepatic resection in patients with hepatocellular carcinoma.

Hepatology research : the official journal of the Japan Society of Hepatology

Shinji Itoh, Tomoharu Yoshizumi, Ken Shirabe, Koichi Kimura, Hirohisa Okabe, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Akihiro Nishie, Yoshihiko Maehara

Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  2. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

PMID: 27283504 DOI: 10.1111/hepr.12761

Abstract

AIM: We aimed to evaluate whether functional assessment of the future remnant liver is a predictor of postoperative morbidity after hepatic resection in patients with hepatocellular carcinoma (HCC).

METHODS: One hundred forty-six patients who underwent hepatic resection for HCC were enrolled in this study. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI (EOB-MRI) analysis for functional liver assessment was carried out before hepatic resection. The signal intensity in the remnant liver was measured and divided by the signal intensity of the major psoas muscle (the liver to major psoas muscle ratio, LMR) for standardization. The remnant liver function was calculated using the formula (LMR on the hepatobiliary phase/LMR on the precontrast image). Computed tomography liver volumetry was also carried out. The remnant functional liver was calculated as the remnant liver volume or volumetric rate × remnant liver function by EOB-MRI.

RESULTS: Morbidities developed in 19 (13.0%) patients. Morbidities associated with the liver occurred in 7 patients (4.7%). There was no mortality during surgery. Median remnant liver function scores using EOB-MRI and remnant functional liver using volumetric rate or volumetry were 1.82 (range, 1.25-2.96), 155.9 (range, 64.7-285.3), and 1027 (range, 369-2148), respectively. Logistic regression analysis identified the remnant functional liver volume as the only independent predictor for liver-related morbidity.

CONCLUSION: Remnant functional liver volume using computed tomography liver volumetry and EOB-MRI was a significantly useful predictor for liver-related morbidity after hepatic resection in patients with HCC.

© 2016 The Japan Society of Hepatology.

Keywords: EOB-MRI; functional remnant liver; hepatic resection; morbidity

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