The significance of measuring liver volume using computed tomographic images before and after hepatectomy

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Abstract
The authors have developed a system to measure the volume of the liver parenchyma and tumors using computed tomographic images printed on film. The present study was carried out to clarify the usefulness of this method to assess both liver volume and the relationship between the volume increase and the functional recovery. We investigated 55 patients who underwent a hepatic resection of more than one segment. We calculated the effective resection ratio and the liver volume increase at the 4th postoperative week to evaluate postoperative hepatic insufficiency. The liver volume increase 4 weeks after surgery correlated significantly with the effective resection ratio and also showed an inverse correlation with the severity of chronic changes in the liver. The liver volume increase also inversely correlated with the preoperative retention of indocyanine green at 15 min. Patients with postoperative hepatic insufficiency tended to show a smaller liver volume increase than expected for their resection ratio. In contrast, noncirrhotic patients had no such particular tendency. In conclusion, measurement of the liver volume using this technique appears to be a simple and useful method to evaluate liver volume after resection; as such, it may also be used to evaluate hepatic regeneration after resection.