Preoperative right portal vein embolization in patients with metastatic liver disease. Metastatic liver volumes after RPVE.
OBJECTIVE
To quantify liver metastases and future remnant liver (FRL) volumes in patients who underwent right portal vein embolization (RPVE) and to evaluate the effects of this procedure on metastase growth.


METHODS
Nine patients with liver metastases from primary colon (n = 5), rectal lesions (n = 1) and carcinoid tumors (n = 3) underwent spiral CT to evaluate the ratio of the non-tumorous parenchymal volume of the resected liver to that of the whole liver volume (R2). Hand tracing was used to isolate the entire liver, the resected liver and metastase volumes. All patients with R2 > 60% underwent RPVE.


RESULTS
FRL exhibited a 101-336 cm3 (average 241 cm3) increase in volume 1 month after RPVE. One patient refused surgery for 2 months and before surgery the increase in volume of the FRL was similar to that of other patients (180.64 cm3). Percent metastases volume from colorectal carcinoma in embolized liver parenchyma increased from 62.4% to 138.4% at 1 month and to 562% at 2 months after RPVE. Metastase volume from carcinoid tumors was unchanged.


CONCLUSIONS
One month after RPVE, hypertrophy of the FRL is evident. In the embolized liver, there was a progressive increase in metastase volume from colorectal carcinoma while metastase volume from carcinoid tumor was unchanged in embolized and non-embolized liver.
Barbaro
B
B
Department of Radiology, Università Cattolica, Policlinico Agostino Gemelli, Rome, Italy. a.leonemd@tiscalinet.it
Di Stasi
C
C
Nuzzo
G
G
Vellone
M
M
Giuliante
F
F
Marano
P
P
D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods*; D012720:Severity of Illness Index; D013997:Time Factors; D036542:Tomography, Spiral Computed / Q000379:methods*