Liver volume is a prognostic indicator for clinical outcome of patients with alcoholic hepatitis.
To evaluate the prognostic value of abdominal computed tomography (CT) in patients with alcoholic hepatitis (AH).



This ancillary study was based on data collected during a previous randomized controlled trial in patients with AH. Clinical response was defined as the improvement of the baseline MELD score ≥3 points at 3 months. All patients underwent contrast-enhanced CT of the abdomen. The following parameters were measured: (1) liver density, spleen density, and liver-to-spleen density ratio; (2) liver-to-body weight (LBW) ratio; and (3) subcutaneous fat, visceral fat, and muscular content. Improvers and non-improvers were compared with univariate, multivariate, and ROC analyses. Results were compared with a validation cohort of patients.



Fifty-eight patients (mean age, 56 years) were analyzed, including 34 (59 %) improvers. On multivariate analysis, LBW ratio (OR = 3.73; 95 % CI, 1.65-8.46; p = 0.002) and subcutaneous fat (OR = 1.01; 95 % CI, 1.00-1.02; p = 0.022) were associated with clinical response, with AUROC curves of 0.78 ± 0.06 (p < 0.001) and 0.66 ± 0.07 (p = 0.043), respectively. LBW ≥2.4 % predicted response with 88 % sensitivity and 63 % specificity. In the validation cohort (n = 42, 64 % improvers), the same cut-off value predicted response with 93 % sensitivity and 60 % specificity.



In patients suffering from AH, the liver volume appears to be a major positive prognostic factor.
Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.|Department of Radiology, University Hospitals of Beaujon, Paris, France.
Romain
R
Breguet
Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.|Department of Radiology, University Hospitals of Beaujon, Paris, France.
Maxime
M
Ronot
Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.|Department of Gastroenterology and Hepatology, University Hospitals of Geneva, Geneva, Switzerland.
Nicolas
N
Goossens
Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
Catrina
C
Hansen
Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.|Department of Gastroenterology and Hepatology, University Hospitals of Geneva, Geneva, Switzerland.
Emiliano
E
Giostra
Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.|Department of Visceral Surgery, University Hospitals of Geneva, Geneva, Switzerland.
Pietro
P
Majno
Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
Christoph D
CD
Becker
Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.|Department of Gastroenterology and Hepatology, University Hospitals of Geneva, Geneva, Switzerland.
Laurent
L
Spahr
Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland. sylvain.terraz@hcuge.ch.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland. sylvain.terraz@hcuge.ch.
Sylvain
S
Terraz
D001823:Body Composition; D003287:Contrast Media; D005260:Female; D006519:Hepatitis, Alcoholic / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
D003287:Contrast Media
Alcoholic hepatitis; Body composition; Computed tomography; Prognostic factors; Volumetry