Quantitative Imaging Features and Postoperative Hepatic Insufficiency: A Multi-Institutional Expanded Cohort

摘要: Background Post-hepatectomy liver insufficiency (PHLI) is a significant cause of morbidity and mortality after resection. Quantitative imaging analysis using CT scans measures variations in pixel intensity related to perfusion. A preliminary study demonstrated correlation between quantitative features the future remnant (FLR) parenchyma from preoperative PHLI. The objective this was explore potential application PHLI an expanded, multi-institutional cohort. Study Design We retrospectively identified patients 5 high-volume academic centers who developed major hepatectomy, matched them control without (by extent resection, chemotherapy treatment, age [±5 years], sex). were extracted FLR scan, most discriminatory conditional logistic regression. Percent volume (RLV) defined as follows: (FLR volume)/(total volume) × 100. Significant clinical combined multivariate Results From 2000 2015, 74 with controls identified. common indications for surgery colorectal metastases (53%), hepatocellular carcinoma (37%), cholangiocarcinoma (9%). Two (FD1_4: image complexity; ACM1_10: spatial distribution intensity) strongly associated with PHLI remained on (p = 0.018 p = 0.023, respectively), independent variables, including bilirubin %RLV. Conclusions are independently promising risk stratification tool.