Prognostic role of spleen volume measurement using computed tomography in patients with compensated chronic liver diseas
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COMPUTED TOMOGRAPHY
Prognostic role of spleen volume measurement using computed tomography in patients with compensated chronic liver disease from hepatitis B viral infection Jeongin Yoo 1 & Sun Woong Kim 2,3 & Dong Ho Lee 1,4
&
Jae Seok Bae 1 & Eun Ju Cho 2
Received: 20 February 2020 / Revised: 9 July 2020 / Accepted: 19 August 2020 # European Society of Radiology 2020
Abstract Objectives To determine the prognostic value of CT-based splenic volume measurement in patients with compensated chronic liver disease (cCLD) from chronic hepatitis B (CHB). Methods A total of 584 patients having multiphasic liver CT scans between January and December 2011 were retrospectively reviewed. Spleen volume was measured using a semi-automated three-dimensional volumetric software program. Electronic medical records and national registry data were reviewed to determine the diagnosis of hepatocellular carcinoma (HCC), hepatic decompensation, or death. The cumulative incidence (CI) of the development of decompensation, HCC occurrence, and overall survival (OS) were estimated by the Kaplan-Meier method. The Cox proportional hazard regression model was used to evaluate prognostic factors. The optimal cutoff spleen volume to predict each outcome was obtained using a minimal p value approach method. Results After a median follow-up of 92 months, 114 patients developed HCC with a 7-year CI of 17.2%. A larger spleen volume was a significant predictor of HCC occurrence (HR = 2.13, p = 0.009). Decompensation occurred in 30 patients with a 7-year CI of 5.0%, and a larger spleen volume was also significantly associated with the development of decompensation (HR = 4.66, p = 0.005). Twenty-three patients died, and their estimated 7-year OS was 96.4%. A larger spleen volume also significantly affected OS (HR = 6.15, p = 0.007). The optimal cutoff spleen volume was set at 532 mL for HCC occurrence, 656.9 mL for the development of decompensation, and 741.1 mL for OS. Conclusions A larger spleen volume was significantly associated with HCC occurrence, development of decompensation, and poor OS in patients with cCLD from CHB. Key Points • Spleen volume could be easily acquired from routine multiphasic liver CT scan using a semi-automated 3D volumetric software program with excellent inter-observer agreement. • A larger spleen volume was significantly associated with a higher rate of hepatocellular carcinoma occurrence, the development of decompensation, and poor overall survival in patients with compensated chronic liver disease from chronic hepatitis B. Keywords Chronic hepatitis B . Splenomegaly . Multidetector computed tomography . Liver cirrhosis . Hepatocellular carcinoma
Jeongin Yoo and Sun Woong Kim equally contributed to this work as cofirst authors. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-07209-6) contains supplementary material, which is available to authorized users. * Dong Ho Lee [email protected] 1
Department of Radiology, Seoul National University Hospital, 101 Da
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