Validation of a semi-automatic method to measure total liver volumes in polycystic liver disease on computed tomography — high speed and accuracy
By
Sophie E. Aapkes
Thijs R. M. Barten
Walter Coudyzer
Joost P. H. Drenth
Ivo M. A. Geijselaers
Sterre A. M. ter Grote
Ron T. Gansevoort
Frederik Nevens
Maatje D. A. van Gastel
January 14, 2023
Clinical Scorecard: Assessment of a semi-automated technique for quantifying total liver volumes in polycystic liver disease via computed tomography — enhanced speed and precision
At a Glance
Category Detail
Condition Polycystic liver disease (PLD) characterized by >10 hepatic cysts causing hepatomegaly Key Mechanisms Inherited diseases ADPLD and ADPKD cause cyst formation; liver enlargement leads to mechanical compression and symptoms Target Population Patients with PLD including those with ADPLD and ADPKD Care Setting Tertiary referral centers and clinical care settings performing CT imaging
Key Highlights
Total liver volume (TLV) correlates with symptom severity and is critical for disease monitoring and treatment evaluation Manual TLV measurement is gold standard but time-consuming, requiring expert knowledge and prone to interobserver variability Semi-automatic segmentation using Siemens MMWP Volume tool offers faster, reliable TLV measurement across diverse CT protocols Guideline-Based Recommendations
Diagnosis
Use axial CT scans for TLV measurement in PLD patients Exclude incomplete CT scans or scans missing liver slices Apply manual or semi-automatic segmentation methods for liver boundary delineation Management
Monitor TLV longitudinally to assess disease progression and treatment response Consider semi-automatic segmentation to improve efficiency and reproducibility in clinical practice Monitoring & Follow-up
Perform TLV measurements at intervals of at least 6 months Use consistent CT protocols when possible to enhance comparability Ensure observers are blinded to prior measurements to reduce bias Risks
Potential variability in TLV measurement due to different observers and CT protocols Exclusion of extrahepatic structures is necessary to avoid volume overestimation Patient & Prescribing Data
PLD patients undergoing CT imaging for liver volume assessment
Precise TLV measurement with accuracy better than mean annual liver growth (~3.9%) is essential to evaluate treatment efficacy
Clinical Best Practices
Use semi-automatic segmentation tools with HU density thresholds to exclude non-liver tissues Coarsely contour liver every three slices and adjust interpolated slices for accuracy Perform inter- and intra-reader reproducibility assessments to ensure measurement reliability Record and compare measurement times to optimize workflow efficiency Maintain blinding of observers to patient identity and time points during measurements References
