Liver Three-Dimensional Reconstruction Accurately Predicts Remnant Liver Volume for HBV-Related Hepatocellular Carcinoma Prior to Hepatectomy

Accurate prediction of future remnant liver volume preoperatively is vital to avoid posthepatectomy liver failure (PHLF). In this study, we evaluated the accuracy and efficiency of Myrian software for predicting resected liver volume and future remnant liver volume for hepatitis B virus (HBV)-related hepatocellular carcinoma prior to liver resection. Patients with HBV-related hepatocellular carcinoma undergoing liver three-dimensional CT reconstruction prior to or after hepatectomy were enrolled in this study. All three-dimensional reconstructions were completed by two observers (observers 1 and 2) separately. Resected specimen weights were obtained in the operating room after liver resection. The correlations between resected liver volume and resected specimen weights, planned remnant liver volume (RLV) and actual RLV were analyzed. Bland-Altman plots were used to assess interobserver variability between observers 1 and 2. A total of 42 patients were enrolled in the study, including 32 men and 10 women with a median age of 49 years. The mean time needed to perform complete volumetry in a patient was 20.8 ± 2.9 min and 23.7 ± 3.8 min for observers 1 and 2, respectively. The resected liver volume of observers 1 and 2 measured by Myrian software correlated strongly with the resected specimen weight (P < 0.0001, r = 0.980; P < 0.0001, r = 0.982, respectively). Pearson’s correlation analysis showed that the planned RLV had a strong positive correlation with the actual RLV for observers 1 and 2 (P < 0.0001, r = 0.957; P < 0.0001, r = 0.949, respectively). Low interobserver variability was observed between observers 1 and 2. Liver three-dimensional CT reconstruction can accurately predict resected liver volume and future remnant liver volume for HBV-related hepatocellular carcinoma prior to liver resection.