Publication

Accuracy of Estimation of Graft Size for Living-Related Liver Transplantation: First Results of a Semi-Automated Interactive Software for CT-Volumetry

Liver surgery

PLoS One. 2014 Oct 17;9(10).

Authors:

T. Mokry, N. Bellemann, D. Müller, J.L. Bermejo, M. Klauß, U. Stampfl, B. Radeleff, P. Schemmer, H-U Kauczor, C-M. Sommer

Summary

The publication evaluates the performance of a semi-automated software tool for preoperative graft volume estimation in living donor liver transplantation (LDLT). The study focuses on comparing CT volumetry measurements obtained via this software with intraoperative graft weight measurements to assess accuracy.

Key findings include:

  • Volume Accuracy: TR (with vessels): 642.9 ± 368.8 ml, P (with vessels): 623.8 ± 349.1 ml, P (without vessels): 605.2 ± 345.8 ml (P < 0.01 vs. TR).
  • Regression vs. Intraoperative Weight: TR: y = 0.94x + 30.1 (R² = 0.92), P (with vessels): y = 1.00x + 12.0 (R² = 0.92), P (without vessels): y = 1.01x + 28.0 (R² = 0.92).
  • Error Ratios: TR: −1.5 ± 14.2%, P (with vessels): −2.7 ± 13.0%, P (without vessels): −6.5 ± 14.1% (P < 0.01 across methods).
  • Inter-Observer Agreement: Bias of 1.8 ml (TR) vs. 5.4 ml (P with vessels).
  • Workflow: P required less manual correction and was faster (Likert scores: 2.4–2.6 vs. TR).

The software offers the ability to streamline the segmentation of liver regions and its application in calculating graft volumes. The authors report strong correlation coefficients between CT-derived graft volume estimates and actual intraoperative graft weights, suggesting the tool's clinical reliability. The results indicate that the semi-automated approach reduces manual intervention while maintaining diagnostic accuracy. The study underscores the software's potential to standardize preoperative planning and improve safety outcomes for donors and recipients in LDLT.

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