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J Hepatobiliary Pancreat Sci. 2019 May 9. doi: 10.1002/jhbp.633. [Epub ahead of print]

Dilatation of left portal vein after right portal vein embolization: a simple estimation for growth of future liver remnant.

Author information

1
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
2
School of Computer Science and Engineering, Soongsil University, Seoul, Korea.
3
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
4
Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND:

To evaluate correlation between growth rate of left portal vein (LPV) and future liver remnant (FLR) after right portal vein embolization (PVE), and to design models predicting FLR growth rate and volume using LPV area measurements on computed tomography (CT).

METHODS:

A total of 134 patients (59.6 ± 10.2 years; 103 men) who underwent right PVE with contrast-enhanced CT before and 3-5 weeks after PVE were retrospectively identified. Kinetic hypertrophy ratio (KHR) and kinetic degree of hypertrophy (KDH) served as growth rate parameters. Correlations between LPV growth rate and FLR growth rate and volume change were evaluated by linear regression analysis. The agreements between actual volumetrically determined growth rates and volume of FLR and those estimated from regression equation using LPV measurements were assessed by Bland-Altman plots.

RESULTS:

Growth rates of LPV and FLR correlated significantly (P < 0.001). The mean difference between actual and estimated value was 0.1% for KHR-FLR (actual, 9.5 ± 6.0%; estimated, 9.4 ± 3.8%), 0.0% for KDH-FLR (actual, 3.3 ± 1.4%; estimated, 3.3 ± 0.7%), -3.8 cm3 for FLR volume (actual, 642.5 ± 167.8 cm3 ; estimated, 646.4 ± 156.5 cm3 ), and -0.1% for proportion of FLR volume (actual, 48.7 ± 7.8%; estimated, 48.9 ± 7.8%).

CONCLUSIONS:

After right PVE, FLR growth rate and volume can be simply estimated from the change in LPV area.

KEYWORDS:

Decision support model; Liver regeneration; Multidetector computed tomography; Portal vein embolization

PMID:
31070855
DOI:
10.1002/jhbp.633

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