title: Hepatosplenic volumetric assessment at MDCT for staging liver fibrosis.
abstract: OBJECTIVE
  To investigate hepatosplenic volumetry at MDCT for non-invasive prediction of hepatic fibrosis.
  
  
  METHODS
  Hepatosplenic volume analysis in 624 patients (mean age, 48.8 years; 311 M/313 F) at MDCT was performed using dedicated software and compared against pathological fibrosis stage (F0 = 374; F1 = 48; F2 = 40; F3 = 65; F4 = 97). The liver segmental volume ratio (LSVR) was defined by Couinaud segments I-III over segments IV-VIII. All pre-cirrhotic fibrosis stages (METAVIR F1-F3) were based on liver biopsy within 1 year of MDCT.
  
  
  RESULTS
  LSVR and total splenic volumes increased with stage of fibrosis, with mean(±SD) values of: F0: 0.26 ± 0.06 and 215.1 ± 88.5 mm3; F1: 0.25 ± 0.08 and 294.8 ± 153.4 mm3; F2: 0.331 ± 0.12 and 291.6 ± 197.1 mm3; F3: 0.39 ± 0.15 and 509.6 ± 402.6 mm3; F4: 0.56 ± 0.30 and 790.7 ± 450.3 mm3, respectively. Total hepatic volumes showed poor discrimination (F0: 1674 ± 320 mm3; F4: 1631 ± 691 mm3). For discriminating advanced fibrosis (≥F3), the ROC AUC values for LSVR, total liver volume, splenic volume and LSVR/spleen combined were 0.863, 0.506, 0.890 and 0.947, respectively.
  
  
  CONCLUSIONS
  Relative changes in segmental liver volumes and total splenic volume allow for non-invasive staging of hepatic fibrosis, whereas total liver volume is a poor predictor. Unlike liver biopsy or elastography, these CT volumetric biomarkers can be obtained retrospectively on routine scans obtained for other indications.
  
  
  CONCLUSIONS
  • Regional changes in hepatic volume (LSVR) correlate well with degree of fibrosis. • Total liver volume is a very poor predictor of underlying fibrosis. • Total splenic volume is associated with the degree of hepatic fibrosis. • Hepatosplenic volume assessment is comparable to elastography for staging fibrosis. • Unlike elastography, volumetric analysis can be performed retrospectively.
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA. ppickhardt2@uwhealth.org.
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Malecki
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA.
authors.forename: Oliver F
authors.initials: OF
authors.lastname: Hunt
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: Beaumont
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA.
authors.forename: John
authors.initials: J
authors.lastname: Kloke
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Ziemlewicz
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI, 53792-3252, USA.
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubner
mesh_terms: D001706:Biopsy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009929:Organ Size; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013154:Spleen / Q000000981:diagnostic imaging*
keywords: Cirrhosis; Liver fibrosis; MDCT; Volume; Volumetric analysis