title: Novel three-dimensional imaging technique improves the accuracy of hepatic volumetric assessment.
abstract: BACKGROUND
  With pre-operative prediction of liver volume becoming increasingly important to safely carry out complex hepatic resections, the aim of the present study was to validate the accuracy of a three-dimensional (3-D) liver surgery operative planning software in performing hepatic volumetry.
  
  
  METHODS
  Between 1999 and 2007, we performed 29 live donor liver resections for transplantation. Eleven patients had pre-operative volumetry performed by radiologists from either computed tomography (CT) or magnetic resonance (MR) imaging with documentation of the corresponding specimen weight. Retrospectively, images were uploaded into Scout™ where 3-D models of each case were generated to perform volumetry. A correlational analysis was performed followed by an accuracy comparison.
  
  
  RESULTS
  Estimations by both radiologists and Scout™ were significantly correlated with the specimen weights, P ≤ 0.0001. Compared with radiologists' volumetry, Scout™ significantly improved overall accuracy [per cent error (PE) 20.0% ± 5.3 vs. 32.9% ± 5.7, P=0.005], accuracy of CT-based estimations (PE 23.2% ± 6.7 vs. 37.2% ± 6.9, P=0.023) and accuracy of the left lateral section (PE 11.1% ± 3.9 vs. 26.6% ± 6.8, P=0.027).
  
  
  CONCLUSIONS
  This 3-D planning software is a valid tool for use in volumetry. Significance is greatest for CT-based models of the left lateral section. This approach gives surgeons the ability to assess volumetrics and actively plan resections.
authors.affiliation: Department of Surgery, Washington University in Saint Louis, Saint Louis, MO 63110, USA.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: DuBray
authors.forename: Rebecca V
authors.initials: RV
authors.lastname: Levy
authors.forename: Parvathi
authors.initials: P
authors.lastname: Balachandran
authors.forename: Kendra D
authors.initials: KD
authors.lastname: Conzen
authors.forename: Gundumi A
authors.initials: GA
authors.lastname: Upadhya
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Anderson
authors.forename: William C
authors.initials: WC
authors.lastname: Chapman
mesh_terms: D006498:Hepatectomy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008279:Magnetic Resonance Imaging; D008923:Missouri; D009929:Organ Size; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012984:Software; D014057:Tomography, X-Ray Computed