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

作者：Krishnamurthy Gerbail T^*; Krishnamurthy Shakuntala; Milleson Thomas; Minnick Doug; Brown Paul H

来源：Nuclear Medicine Communications, 2009, 30(12): 945-955.

DOI：10.1097/MNM.0b013e32832ed3ea

• cholescintigraphy
• liver size
• nuclear hepatology software
• quantification of liver function
• segmental liver function

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 (99m)Tc-HIDA dicom image data transferred from a lambda 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 +/- 3 cm(2), left lobe 96 +/- 4 cm(2), and total liver area 212 +/- 3 cm(2). 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 +/- 419 ml, left lobe 434 +/- 221 ml, and total liver volume 1628 +/- 490 ml. Right lobe area wasl 120 +/- 30 cm(2), left lobe (plus caudate) 88 +/- 29 cm(2) with total liver area of 208 +/- 51 cm(2). 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 (99m)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.

• 出版日期2009-12