Introduction
Methods
Literature search strategy
Eligibility criteria and study selection
Data extraction
Results
Study demographics of the included papers
Author | Year | Country | Prospective study | Consecutive recruitment | Tracer | Patients (n) | Postoperative outcome | Major/minor surgery or both | Morphological volume assessment, CT/MRI | Preoperative, combined preoperative/peroperative volumetric measurement or both | Combined volumetric/ functional (NMI) parameter | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Mortality | Liver failure | |||||||||||
Chapelle et al. [18] | 2016 | Belgium | Yes | Yes | [99mTc]Tc-Meb | 88 | Yes | Yes | Both | MRI | Preoperative | Yes |
Chapelle et al. [27] | 2017 | Belgium | Yes | Yes | [99mTc]Tc-Meb | 188a | Yes | Yes | Both | MRI | Preoperative | Yes |
Chapelle et al. [26] | 2017 | Belgium | No | Yes | [99mTc]Tc-Meb | 140 | No | Yes | Both | MRI | Preoperative | Yes |
Cho et al. [14] | 2017 | Korea | No | Yes | [18F]FDG | 149 | No | Yes | Both | CT | Preoperative | Yes |
Cieslak et al. [21] | 2016 | The Netherlands | No | Yes | [99mTc]Tc-Meb | 163 | Yes | Yes | Major | CT | Preoperative | No |
de Graaf et al. [10] | 2010 | The Netherlands | No | Yes | [99mTc]Tc-Meb | 55 | No | Yes | Major | CT | Preoperative | No |
Dinant et al. [19] | 2007 | The Netherlands | Yes | Yes | [99mTc]Tc-Meb | 46 | Yes | Yes | Both | CT | Preoperative | No |
Fujioka et al. [33] | 1999 | Japan | No | No | [99mTc]Tc-GSA | 15 | Yes | No | Both | CT | Preoperative | No |
Hayashi et al. [20] | 2015 | Japan | No | Yes | [99mTc]Tc-GSA | 133 | Yes | Yes | Major | CT | Preoperative | No |
Hirai et al. [24] | 2003 | Japan | No | Yes | [99mTc]Tc-GSA | 30 | No | Yes | Major | CT | Preoperative | No |
Kokudo et al. [17] | 2002 | Japan | No | Yes | [99mTc]Tc-GSA | 111 | No | Yes | Minor | CT | Combined | Yes |
Kwon et al. [34] | 2001 | Japan | No | Yes | [99mTc]Tc-GSA | 47 | Yes | No | Bothb | CT | Preoperative | No |
Kwon et al. [35] | 2004 | Japan | No | No | [99mTc]Tc-GSA | 32 | Yes | No | Both | CT | Preoperative | No |
Kwon et al. [36] | 2006 | Japan | No | Yes | [99mTc]Tc-GSA | 178 | Yes | No | Bothb | CT | Preoperative | No |
Nanashima et al. [32] | 2007 | Japan | No | Yes | [99mTc]Tc-GSA | 185 | No | Yes | Both | CT | Preoperativec | No |
Nanashima et al. [37] | 2013 | Japan | No | No | [99mTc]Tc-GSA | 67 | No | Yes | Bothb | CT | Preoperative | No |
Okabe et al. [30] | 2014 | Japan | Yes | Yes | [99mTc]Tc-GSA | 625 | No | Yes | Bothb | CT | Preoperative | No |
Olthof et al. [22] | 2017 | The Netherlands | No | Yes | [99mTc]Tc-Meb | 116 | Yes | Yes | Major | CT | Preoperative | No |
Otsuki et al. [15] | 1997 | Japan | Yes | No | [11C]C-Met | 11 | Yes | No | Major | CT | Preoperative | Yes |
Rassam et al. [23] | 2019 | The Netherlands | No | Yes | [99mTc]Tc-Meb | 71 | Yes | Yes | Both | CT | Preoperative | No |
2018 | Argentina | No | Yes | [99mTc]Tc-Meb | 20 | No | Yes | Major | CT or MRI | Preoperative | No | |
Serenari et al. [29] | 2019 | Italy | No | Yes | [99mTc]Tc-Meb | 27 | No | Yes | Major | CT | Preoperative | No |
Truant et al. [38] | 2017 | France | Yes | Yes | [99mTc]Tc-Meb | 100 | Yes | No | Major | CT | Preoperative | No |
Yoshida et al. [31] | 2012 | Japan | No | No | [99mTc]Tc-GSA | 256 | No | Yes | Both | CT | Preoperative | Yes |
Yumoto et al. [16] | 2010 | Japan | No | Yes | [99mTc]Tc-GSA | 101 | No | Yes | Both | CT | Both | No |
Prediction of postoperative mortality
Author | Mortality defined | Mortality event rate | Preset cutoff studied | Post hoc cutoff value established | Only descriptive analysis | Mortality versus no mortality comparison | Key diagnostic characteristics reported | CT/MRI or NMI predictive in univariable regression analysis | CT/MRI or NMI predictive in multivariable regression analysis | Comparison of predictive value |
---|---|---|---|---|---|---|---|---|---|---|
Dinant et al. [19] | No | 11% | NMI/CT: No | NMI: Yes CT: No | No | NMI/CT: Yes | NMI/CT: Yes | NMI: Yes CT: NR | NMI: No CT: NR | NR |
Chapelle et al. [18] | Yes | 6% | NMI/MRI: Noa | NMI/MRI: Yesb | Yes | NR | NR | NR | NR | NR |
Chapelle et al. [27] | Yes | 0%c | NMI/MRI: Yesb | NMI/MRI: No | Yes | NR | NR | NR | NR | NR |
Cieslak et al. [21] | Yes | 7% | NMI/CT: Yesb | NMI/CT: No | Yes | NR | NR | NR | NR | NR |
Fujioka et al. ≠ [33] | No | 7% | NMI/CT: No | NMI: Yesb CT: No | Yes | NR | NR | NR | NR | NR |
Hayashi et al. [20] | Yes | 6% | NMI/CT: Yesb | NMI/CT: No | No | NMI/CT: NR | NMI/CT: NR | NMI: Yes CT: No | NMI/CT: NR | NR |
Kwon et al. [34] | No | 2% | NMI/CT: No | NMI/CT: Yesb | Yes | NR | NR | NR | NR | NR |
Kwon et al. [35] | No | 3% | NMI/CT: No | NMI/CT: Yesb | Yes | NR | NR | NR | NR | NR |
Kwon et al. ≠ [36] | No | 1% | NMI/CT: No | NMI: Yesb CT: No | Yes | NR | NR | NR | NR | NR |
Olthof et al. [22] | Yes | 18% | NMI/CT: Yesb | NMI: Yesb CT: No | No | NMI/CT: NR | NMI: Yesb CT: Yes | NMI/CT: NR | NMI/CT: NR | NR |
Otsuki et al. [15] | No | 27% | NMI/CT: No | NMI: Yesb CT: No | NMI: No CT: Yes | NMI: Yes CT: NR | NMI/CT: NR | NMI/CT: NR | NMI/CT: NR | NR |
Rassam et al. [23] | Yes | 11% | NMI: Yesb CT: No | NMI/CT: No | No | NMI/CT: Yes | NMI/CT: NR | NMI/CT: NR | NMI/CT: NR | NR |
Truant et al. [38] | No | 14%d | NMI/CT: No | NMI/CT: No | Yes | NR | NR | NR | NR | NR |
Prediction of postoperative liver failure
Author | LF defined | LF event rate | Preset cutoff value studied | Post hoc cutoff value established | Only descriptive analysis | LF versus no LF comparison | Key diagnostic characteristics reported | Cutoff value predictive in univariable regression analysis | Cutoff value predictive in multivariable regression analysis |
---|---|---|---|---|---|---|---|---|---|
Chapelle et al. [18] | Yes | 14% | NMI/MRI/Combined: No | NMI: No MRI/Combined: Yesa | No | NMI/MRI/Combined: Yes | NMI: No MRI/Combined: Yes | NMI: Yes MRI: Yes Combined: Yes | NMI: No MRI: No Combined: Yes |
Chapelle et al. [27] | Yes | 1%b | NMI: No MRI: Yes Combined: Yes | NMI/MRI/Combined: No | Yes | NR | NR | NR | NR |
Chapelle et al. [26] | Yes | 15% | NMI/MRI: No Combined: Yes | NMI/MRI/Combined: No | No | NMI/MRI/Combined: Yes | NMI/MRI/Combined: Yes | NMI: No MRI: Yes Combined: Yes | NMI: NR MRI: NR Combined: Yes |
Cho et al. [14] | Yes | 5% | NMI/CT/Combined: No | NMI/CT/Combined: Yes | No | NMI/CT/Combined: Yes | NMI/CT/Combined: Yes | NMI: No CT: Yes Combined: Yes | NMI: NR CT: No Combined: Yes |
Cieslak et al. [21] | Yes | 2% | NMI/CT: Yes | NMI/CT: No | Yes | NR | NR | NR | NR |
de Graaf et al. [10] | Yes | 16% | NMI: No CT: Yes | NMI: Yes CT: No | No | NMI/CT: Yes | NMI/CT: Yes | NMI/CT: NR | NMI/CT: NR |
Dinant et al. [19] | Yes | 13% | NMI/CT: No | NMI: Yes CT: No | No | NMI/CT: Yes | NMI/CT: Yes | NMI: Yes CT: NR | NMI: Yes CT: NR |
Hayashi et al. [20] | Yes | 8% | NMI/CT: Yes | NMI/CT: No | No | NMI/CT: NR | NMI/CT: NR | NMI: Yes CT: No | NMI/CT: NR |
Hirai et al. [24] | Yes | 23% | NMI/CT: No | NMI/CT: Yes | No | NMI/CT: Yes | NMI/CT: Yes | NMI/CT: NR | NMI/CT: NR |
Kokudo et al. [17] | Yesc | 13% | NMI/CT/Combined: No | NMI: No Combined: Yes CT: No | No | NMI/CT/Combined: Yes | NMI/CT/Combined: NR | NMI/CT/Combined: NR | NMI: No CT: NR Combined: Yes |
Nanashima et al. ≠ [32] | Yes | 6% | NMI/CT: No | NMI/CT: Yes | No | NMI/CT: Yes | NMI/CT: NR | NMI/CT: NR | NMI: No CT: Yes |
Nanashima et al. [37] | No | 4% | NMI: Yes CT: No | NMI/CT: No | Yes | NR | NR | NR | NR |
Okabe et al. [30] | Yes | PLD: 7% LF: 2% | NMI: No CT: Yes | NMI: Yes (PLD) CT: No | No | NMI/CT: Yes (PLD) | NMI: Yes (PLD) CT: NR | NMI/CT: NR | NMI: Yes CT: NR (PLD) |
Olthof et al. [22] | Yes | 23% | NMI/CT: Yes | NMI/CT: Yes | No | NMI/CT: Yes | NMI/CT: Yes | NMI/CT: Yes | NMI: Yes CT: No |
Rassam et al. ≠ [23] | Yes | 10% (LF only) | NMI: Yes CT: No | NMI: No CT: No | No | NMI/CT: Yes | NMI/CT: NR | NMI/CT: NR | NMI/CT: NR |
Serenari et al. [28] | Yes | 20%d | NMI/CT/MRI: No | NMI: Yes CT/MRI: No | No | NMI/CT/MRI: Yes | NMI: Yes CT/MRI: NR | NMI/CT/MRI: NR | NMI/CT/MRI: NR |
Serenari et al. [29] | Yes | 33% | NMI: No CT: Yes | NMI/CT: No | NMI: No CT: Yes | NMI: Yes CT: NR | NMI/CT: NR | NMI/CT: NR | NMI/CT: NR |
Yoshida et al. [31] | Yes | 6% | NMI/CT/Combined: No | NMI/Combined: Yes CT: No | No | NMI/CT: Yes Combined: NR | NMI/Combined: Yes CT: NR | NMI/CT/Combined: NR | NMI: Yes CT: No Combined: NR |
Yumoto et al. [16] | Yesc | 17% | NMI/CT: No | NMI: Yes CT: No | No | NMI/CT: Yes | NMI: Yes CT: NR | NMI/CT: NR | NMI/CT: NR |
Author | Cutoff value (variable: value and unit) | LF versus no LF (mean or median, p-value) | Key diagnostic characteristics | Univariable regression analysis (impact, p-value) | Multivariable regression analysis (impact, p-value) | Significant differences in key diagnostic characteristics between NMI and CT/MRI |
---|---|---|---|---|---|---|
Chapelle et al. [18] | NMI: TLF: NR (%/min)a | 5.0 versus 6.2 (p = 0.020) | NR | NR (p = 0.027) | NR (NS) | NR |
CT: FLRV%: 40 (%) | 49 versus 76 (p < 0.001) | Sens 71%, spec 91%, PPV 41%, NPV 97%, AUC 0.77 | For FLRV% < 40: OR 26 (p < 0.001) | NR (NS) | ||
NMI/MRI combined: eFLRF: 2.3 (%/min/m2) | 2.2 versus 4.7 (p < 0.001) | Sens 92%, spec 98%, PPV 92%, NPV 99%, AUC 0.89 | For eFLRF < 2.3: OR 836 (p < 0.001) | NR (p = 0.001) | ||
Chapelle et al. [26] | NMI: HBSBSA: NR (%/min)a | 5.5 versus 6.1 (NS) | AUC 0.652 | NR (NS) | NR (NR) | NR |
CT: FLRV%: NR (%) | 60.6 versus 80.9 (p < 0.001) | AUC 0.800 | NR (p < 0.001) | NR (NR) | ||
NMI/MRI combined: eFLRF: 2.3 (%/min/m2) | 3.3 versus 8.4 (p < 0.001) | AUC 0.843 | NR (p < 0.001) | OR 0.35 (p = 0.002) | ||
Cho et al. [14] | NMI: SUVmean: 2.4 | 2.1 versus 2.3 (NS) | Sens 100%, spec 32%, PPV 7%, NPV 100% | For SUVmean ≤ 2.4: OR 7.0 (NS) | NR (NR) | NR |
CT: Predicted remnant hepatic volume: 415.8 (cm3) | 488.5 versus 652.3 (NS) | Sens 71%, spec 81%, PPV 16%, NPV 98% | For predicted remnant hepatic volume ≤ 415.8: OR 10.6 (p = 0.006) | NR (NS) | ||
CT: RFRHV: 0.3 | 0.4 versus 0.5 (p = 0.007) | Sens 71%, spec 88%, PPV 23%, NPV 98% | For RFRHV ≤ 0.3: OR 18.4 (p = 0.001) | NR (NS) | ||
NMI/CT combined: TLGr: 625.6 | 1067 versus 1491 (NS) | Sens 57%, spec 97%, PPV 44%, NPV 98% | For TLGr ≤ 625.6: OR 36.5 (p < 0.001) | For TLGr ≤ 625.6: OR 82.9 (p < 0.001) | ||
de Graaf et al. [10] | NMI: FRL-F: 2.69 (%/min/m2) | 2.2 versus 4.3 (p = 0.001) | Sens 89%, spec 87%, PPV 57%, NPV 98%, AUC 0.92 | NR (NR) | NR (NR) | NR |
CT: %FRL-V: < 30 (normal liver), < 40 (compromised liver) (%) | 35.0 versus 49.7 (p = 0.013) | Sens 78%, spec 80%, PPV 44%, NPV 95% | NR (NR) | NR (NR) | ||
CT: sFRL: < 30 (normal liver), < 40 (compromised liver) (%) | 35.2 versus 49.2 (p = 0.018) | Sens 67%, spec 87%, PPV 50%, NPV 93% | NR (NR) | NR (NR) | ||
Dinant et al. [19] | NMI: FRL-uptake: 2.5 (%/min/BSA) | 2.3 versus 4.3 (p = 0.003) | Sens 83%, spec 90%, PPV 56%, NPV 97%, AUC 0.90 | NR (p = 0.01) | OR 4.0 (p = 0.03) | NR |
CT: FRL-volume: NR (%) | 42 versus 52 (NS) | AUC 0.65 | NR (NR) | NR (NR) | ||
Hayashi et al. [20] | NMI: Marginal FR function: depending on ICG-value (see paper for further information) (%) | NR (NR) | NR | For marginal FR function versus safe FR function: OR 11.0 (p = 0.001) | NR (NR) | NR |
CT: Marginal FR volume: depending on ICG-value (see paper for further information) (%) | NR (NR) | NR | For marginal FR volume versus safe FR volume: OR 2.3 (NS) | NR (NR) | ||
Hirai et al. [24] | NMI: [99mTc]Tc-GSA uptake in the FLR: 25 (%) | Before PVE: 10.0 versus 25.8 (p = 0.02) After PVE: 18.0 versus 38.4 (p = 0.01) | Sens 50%, spec 94%, AUC 0.97b | NR (NR) | NR (NR) | No |
CT: Ratio of FLR volume to standard liver volume: 35 (%) | Before PVE: 33.0 versus 38.5 (NS) After PVE: 33.7 versus 46.2 (p = 0.003) | Sens 57%, spec 91%, AUC 0.93b | NR (NR) | NR (NR) | ||
Kokudo et al. [17]c | NMI: LHL15: NR | 0.89 versus 0.93 (p = 0.025) | NR | NR (NR) | NR (NS) | NR |
NMI: HH15: NR | 0.58 versus 0.52 (NS) | NR | NR (NR) | NR (NR) | ||
NMI: R0: NR (μmole) | 0.14 versus 0.18 (p = 0.038) | NR | NR (NR) | NR (NS) | ||
NMI: [R]0: NR (μM) | 0.63 versus 0.70 (NS) | NR | NR (NR) | NR (NR) | ||
CT: RPF: NR (%) | 32.5 versus 27.1 (NS) | NR | NR (NR) | NR (NR) | ||
Combined NMI/CT: R0-remnant: 0.16 (μmole) | 0.015 versus 0.024 (p = 0.011) | NR | NR (NR) | Per 0.01 μmole increment: HR 0.82 (p = 0.022) | ||
Nanashima et al. ≠ [32] | NMI: LHL15: 0.85 | 91.1 versus 93.1 (p = 0.014) | NR | NR (NR) | For LHL15 < 0.85 versus ≥ 0.85: OR 1.4 (NS) | NR |
CT: Volume of resected liver: 50 (%) | 45 versus 27 (p < 0.01) | NR | NR (NR) | For volume of resected liver ≥ 50 versus < 50%: OR 7.0 (p = 0.027) | ||
Okabe et al. [30] | NMI: LHL15: 0.93d | 0.92 versus 0.93 (p = 0.0027) | Sens: 88%, spec 96% | NR (NR) | For LHL15 ≤ 0.93: OR 7.4 (p = 0.0082) | NR |
NMI: HH15: NRd | 0.66 versus 0.58 (p = 0.0041) | NR | NR (NR) | NR (NS) | ||
CT: %FLR: NR (%)d | 50.3 versus 50.6 (NS) | NR | NR (NR) | NR (NR) | ||
Olthof et al. [22] | NMI: Total liver function: NR (%/min) | 14.6 versus 16.2 (p = 0.41) | NR | NR (NR) | NR (NR) | NR |
NMI: FLR function: NR (%) | 44.7 versus 63.4 (p < 0.01) | AUC: 0.68 | NR (NR) | NR (NR) | ||
NMI: FLR function: 8.5 (%/min) (post hoc cutoff) | 5.6 versus 8.7 (p < 0.01) | PPV 36%, NPV 91% e, AUC 0.69 | For FLR function < 8.5: OR 5.4 (p < 0.01) | For FLR function < 8.5: OR 4.1 (p < 0.01) | ||
NMI: sFLR function: 2.7 (%/min/m2) (predefined cutoff) | 3.1 versus 4.7 (p < 0.01) | PPV 38%, NPV 82% e, AUC 0.68 | NR (NR) | NR (NR) | ||
CT: FLRV%: 30 (%) (predetermined cutoff), 28.7% (post hoc cutoff) | 43 versus 54 (NS) | Predetermined cutoff: PPV 56%, NPV 83%, AUC 0.60 Post hoc cutoff: PPV 71%, NPV 83% | For FLRV% < 30: OR 5.2 (p < 0.01) | For FLRV% < 30: OR 3.4 (NS) | ||
CT: sFLRV%: NR (%/m2) | NR (NR) | AUC 0.58 | NR (NR) | NR (NR) | ||
CT: FLRV: NR (mL) | 760 versus 986 (NS) | NR | NR (NR) | NR (NR) | ||
CT: Total liver volume: NR (mL) | 2016 versus 1841 (NS) | NR | NR (NR) | NR (NR) | ||
Rassam et al. ≠ [23] | NMI: FRLF: 2.7 (%/min/m2) (predefined cutoff) | NR (NS) | NR | NR (NR) | NR (NR) | NR |
NMI: MUR: NR (%/min) | NR (NS) | NR | NR (NR) | NR (NR) | ||
CT: FRLV%: NR (%) | NR (NS) | NR | NR (NR) | NR (NR) | ||
Serenari et al. [28] | NMI: FLR-C: 34.5 (%) | 30 versus 41 (p = 0.011) | Sens 100%, spec 82%, PPV 50%, NPV 100% | NR (NR) | NR (NR) | NR |
NMI: FLR-F: 1.69 (%/min/m2) | 0.94 versus 2.07 (p = 0.011) | Sens 100%, spec 75%, PPV 50%, NPV 100% | NR (NR) | NR (NR) | ||
NMI: HIBA-i: 14.94 (%) | 12.86 versus 23.29 (p = 0.001) | Sens 100%, spec 94%, PPV 80%, NPV 100% | NR (NR) | NR (NR) | ||
CT: FLR/sTLV: NR (%) | 35 versus 42 (NS) | NR | NR (NR) | NR (NR) | ||
CT: FLR/mTLV: NR (%) | 34 versus 41 (NS) | NR | NR (NR) | NR (NR) | ||
CT: FLR/BW: NR (%) | 0.74 versus 0.88 (NS) | NR | NR (NR) | NR (NR) | ||
Serenari et al. [29] | NMI: FLR-F: NR (%/min/m2) | 1.72 versus 4.02 (NR) | NR | NR (NR) | NR (NR) | NR |
Yoshida et al. [31] | NMI: rLUV(BSA): 27.0 | 23.0 versus 33.6 (p < 0.001)f | Sens 91%, spec 81%, PPV 31%, NPV 99%, AUC 0.89 | NR (NR) | NR (p < 0.001) | NR |
NMI: rLUV(BW): 0.66 | NR (NR) | Sens 80%, spec 84%, PPV 24%, NPV 99%, AUC 0.85 | NR (NR) | NR (NR) | ||
NMI: rLUR: 50.0 (%) | NR (NR) | Sens 93%, spec 66%, PPV 15%, NPV 99%, AUC 0.87 | NR (NR) | NR (NR) | ||
NMI: HH15: NR | 0.64 versus 0.60 (p < 0.05)f | NR | NR (NR) | NR (NS) | ||
NMI: LHL15: NR | 0.90 versus 0.91 (NS)f | NR | NR (NR) | NR (NR) | ||
NMI: %remnant LF: NR (%) | 60.9 versus 75.3 (p < 0.001)f | NR | NR (NR) | NR (NS) | ||
CT: % remnant LV: NR (%) | 61.5 versus 73.7 (p < 0.05)f | NR | NR (NR) | NR (NS) | ||
Combined NMI/CT: rLUV(LV): 0.21 | NR (NR) | Sens 92%, spec 46%, PPV 10%, NPV 99%, AUC 0.73 | NR (NR) | NR (NR) | ||
Yumoto et al. [16] | NMI: R0-remnant: 100 (nmol/liver) | 62.1 versus 122.2 (p < 0.001) | AUC: 0.97 | NR (NR) | NR (NR) | NR |
NMI: [R]0: NR (nmol/l) | 412 versus 551 (p = 0.045) | AUC: 0.80 | NR (NR) | NR (NR) | ||
NMI: R0: NR (nmol/liver) | 149.8 versus 211.2 (p = 0.047) | NR | NR (NR) | NR (NR) | ||
NMI: LHL15: NR | 0.79 versus 0.87 (p = 0.035) | AUC: 0.74 | NR (NR) | NR (NR) | ||
CT: TLV: NR (mL) | 1684.3 versus 1429.7 (NS) | NR | NR (NR) | NR (NR) | ||
CT: Remnant liver volume: NR (mL) | 741.7 versus 854.0 (NS) | NR | NR (NR) | NR (NR) | ||
CT: RPF: NR (%) | 36.9 versus 31.7 (p = 0.046) | NR | NR (NR) | NR (NR) |