Semi-automated CT quantification of liver volume in polycystic liver disease

Overview

This study evaluated a semi-automatic liver segmentation tool (Siemens MMWP Volume) for measuring total liver volume (TLV) in polycystic liver disease (PLD). The semi-automatic method demonstrated reliability and faster processing compared to manual segmentation across diverse CT protocols and liver sizes.

Background

Polycystic liver disease (PLD) is characterized by the presence of more than 10 hepatic cysts causing hepatomegaly and symptoms related to liver enlargement. PLD arises from autosomal dominant polycystic liver disease (ADPLD) or autosomal dominant polycystic kidney disease (ADPKD). Total liver volume (TLV) correlates with symptom severity and is critical for monitoring disease progression and treatment response. Manual TLV measurement is the gold standard but is time-consuming and subject to interobserver variability, highlighting the need for faster, accurate semi-automatic methods.

Data Highlights

Key Findings

• Semi-automatic segmentation using Siemens MMWP Volume is reliable and faster than manual segmentation for TLV measurement in PLD.
• The semi-automatic method effectively excludes extrahepatic structures using Hounsfield unit thresholds, improving accuracy.
• Inter- and intra-reader variability was lower with the semi-automatic technique compared to manual segmentation.
• The method performed well across a wide variety of CT scan protocols and liver sizes, including scans with and without contrast.
• Semi-automatic segmentation allows interpolation between contours, reducing the number of slices requiring manual adjustment.
• Syngo.Via, while allowing interpolation, lacks HU density exclusion and resembles manual segmentation in accuracy and variability.

Clinical Implications

The semi-automatic segmentation tool offers a practical and efficient alternative to manual TLV measurement in PLD, enabling faster and more reproducible assessments. This facilitates longitudinal monitoring of liver volume changes critical for evaluating disease progression and treatment efficacy in clinical practice and trials. Adoption of such tools may reduce observer dependency and resource utilization.

Conclusion

Semi-automatic liver segmentation using Siemens MMWP Volume provides a reliable, faster, and reproducible method for TLV quantification in PLD, addressing limitations of manual segmentation and supporting improved clinical management.

References

1. van Aerts et al. 2024 -- Assessment of a semi-automated technique for quantifying total liver volumes in polycystic liver disease via computed tomography