Development and validation of a comprehensive new hepatobiliary software. Part II: Segmental liver function

Gerbail T. Krishnamurthy, Shakuntala Krishnamurthy, Thomas Milleson, Doug Minnick, Paul H. Brown

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study was undertaken to develop comprehensive new hepatobiliary software to quantify segmental and lobar liver function and to obtain FDA approval. Methods: Hepatobiliary software written on JAVA platform and loaded on to a PC accepts Tc-HIDA dicom image data transferred from a γ camera. Liver boundary was determined by threshold-based auto edge detection and liver height at right midclavicular (RMCL) line. Geometric mean area of the physiologic right lobe, physiologic left lobe and total liver area were measured. Segmental liver function was determined using the 5th minute frame as the default (100%). Results: In 24 control participants, mean (±SD) liver height at RMCL was 14.7±0.12cm. Geometric mean area of the physiologic right lobe was 116±3cm, left lobe 96±4cm, and total liver area 212±3cm. Right upper lobe (segments 7 and 8) contributed 31±0.7%, right lower lobe (segments 5 and 6) 34±0.6%, left medial (segments 4A and 4B) 24±1%, left lateral (segments 2 and 3) 10±2%, and caudate lobe (segment 1) 1±0.02% of total liver function. In 23 patients, contrast three-dimensional computerized tomographic volume of the right lobe was 1194±419ml, left lobe 434±221ml, and total liver volume 1628±490ml. Right lobe area was120±30cm, left lobe (plus caudate) 88±29cm with total liver area of 208±51cm. Right upper lobe (segments 7 and 8) contributed 33±10%, right lower lobe (segments 5 and 6) 34±7%, left medial (segments 4A and 4B) 23±6%, left lateral (segments 2 and 3) 9±3%, and caudate lobe (segment 1) 1±0.4% of total liver function. There was good correlation of RMCL height, and area of right lobe and total liver with computerized tomographic liver volume. Correlation of percentage volume with percentage function was excellent. Conclusion: New FDA approved software provides quantitative assessment of segmental, lobar, and total liver size and function from a planar Tc-HIDA cholescintigraphy and may enable universal standardization in nuclear hepatology. Quantification may aid surgeons in the determination of the amount of tissue resection during liver surgery.

Original languageEnglish (US)
Pages (from-to)945-955
Number of pages11
JournalNuclear Medicine Communications
Volume30
Issue number12
DOIs
StatePublished - Dec 1 2009

Keywords

  • Cholescintigraphy
  • Liver size
  • Nuclear hepatology software
  • Quantification of liver function
  • Segmental liver function

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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