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Comparative Study
. 2011 Feb;35(2):386-92.
doi: 10.1007/s00268-010-0877-6.

Prospective volumetric assessment of the liver on a personal computer by nonradiologists prior to partial hepatectomy

Simon A W G Dello  1 , Jan H M B Stoot, Rogier S A van Stiphout, Johanne G Bloemen, Stephen J Wigmore, Cornelis H C Dejong, Ronald M van Dam
Affiliations
Comparative Study

Prospective volumetric assessment of the liver on a personal computer by nonradiologists prior to partial hepatectomy

Simon A W G Dello et al. World J Surg. 2011 Feb.

Abstract

Background: A small remnant liver volume is an important risk factor for posthepatectomy liver failure. ImageJ and OsiriX® are both free, open-source image processing software packages. The aim of the present study was to compare ImageJ and OsiriX® in performing prospective computed tomography (CT) volumetric analysis of the liver on a personal computer (PC) in patients undergoing major liver resection.

Methods: Patients scheduled for a right hemihepatectomy were eligible for inclusion. Two surgeons and one surgical trainee measured volumes of total liver, tumor, and future resection specimen prospectively with ImageJ and OsiriX®. A radiologist also measured these volumes with CT scanner-linked Aquarius iNtuition® software. Resection volumes were compared with the actual weights of the liver specimens removed during surgery, and differences between the measured liver volumes were analyzed.

Results: A total of 15 patients (8 men, 7 women) with a median age of 63 years (48-79 years) were included. There was a significant correlation between the measured weights of resection specimens and the volumes calculated prospectively with ImageJ and OsiriX® (r=0.89; r=0.83, respectively). There was also a significant correlation between the volumes measured with radiological software iNtuition® and the volumes measured with ImageJ and OsiriX® (r=0.93; r=0.95, respectively).

Conclusions: There were no major differences in total liver volumes, resection volumes, or tumour volumes for these three software packages. Prospective hepatic CT volumetry with ImageJ or OsiriX® is reliable and can be accurately used on a PC by nonradiologists. ImageJ and OsiriX® yield results comparable to the radiological software iNtuition®.

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Figures

Fig. 1
Fig. 1
Correlation between volume measured prospectively with ImageJ, OsiriX®, and iNtuition® and the resected specimen’s weight measured in the operating theater
Fig. 2
Fig. 2
a Bland-Altman analysis for interobserver variability of outlining the total liver volume with ImageJ. Horizontal solid line indicates the mean average between the two users. Horizontal dashed lines indicate 95% limits of agreement (mean ± 1.96 SD). b Bland-Altman analysis for interobserver variability of outlining the resectional liver volume with ImageJ. c Bland-Altman analysis for interobserver variability of the %functional remnant liver volume (%FRLV) with ImageJ
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