title: Is computed tomography volumetric assessment of the liver reliable in patients with cirrhosis?
abstract: OBJECTIVE
  The estimation of liver volume (LV) has been widely studied in normal liver, the density of which is considered to be equivalent to 1 kg/l. In cirrhosis, volumetric evaluation and its correlation to liver mass remain unclear. The aim of this study was to evaluate the accuracy of computed tomography (CT) scanning to assess LV in patients with cirrhosis.
  
  
  METHODS
  Liver volume was evaluated by CT (CTLV) and correlated to the explanted liver weight (LW) in 49 patients. Liver density (LD) and its association with clinical features were analysed. Commonly used formulae for estimating LV were also evaluated. The real density of cirrhotic liver was prospectively measured in explant specimens.
  
  
  RESULTS
  Wide variations between CTLV (in ml) and LW (in g) were found (range: 3-748). Cirrhotic livers in patients with hepatitis B virus infection presented significantly increased LD (P = 0.001) with lower CTLV (P = 0.005). Liver volume as measured by CT was also decreased in patients with Model for End-stage Liver Disease scores of >15 (P = 0.023). Formulae estimating LV correlated poorly with CTLV and LW. The density of cirrhotic liver measured prospectively in 15 patients was 1.1 kg/l.
  
  
  CONCLUSIONS
  In cirrhotic liver, LV assessed by CT did not correspond to real LW. Liver density changed according to the aetiology and severity of liver disease. Commonly used formulae did not accurately assess LV.
authors.affiliation: Department of Hepatobiliary and Transplant Surgery, Saint Antoine Hospital Assistance Publique-Hôpitaux (AP-HP), Paris, France; University Pierre and Marie Curie (UPMC, University of Paris 06), Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Goumard
authors.forename: Fabiano
authors.initials: F
authors.lastname: Perdigao
authors.forename: Julien
authors.initials: J
authors.lastname: Cazejust
authors.forename: Stéphane
authors.initials: S
authors.lastname: Zalinski
authors.forename: Olivier
authors.initials: O
authors.lastname: Soubrane
authors.forename: Olivier
authors.initials: O
authors.lastname: Scatton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed