Table 1.
Patient Demographics.
Figure 1.
Semi-automated Interactive Software for CT-volumetry (P) – Manual Positioning of 9 Anatomical Landmarks to Define the Segments of Couinaud (Schematic Illustration; Courtesy of Philips Healthcare Germany, Hamburg, Germany).
A first bifurcation of the right portal vein (black circle). B inferior caval vein (black circle). C right hepatic vein (black circle). D middle hepatic vein (black circle). E left hepatic vein (black circle). F superficial ligamentum venosum (black circle). G deep ligamentum venosum (black circle). H end of left portal vein (black circle). I left liver tip (black circle) Note: after automated outline of the entire liver with correction of false-positive and false-negative extractions, and then after manual positioning of the 9 anatomical landmarks, volumes of transplanted liver segments are obtained.
Table 2.
Intraoperative Weights and Volumes of Transplanted Liver Segments.
Figure 2.
Linear Regression Analysis between Intraoperative Weights and Volumes of Transplanted Liver Segments.
A For the manual commercial software (TR) with vessels, the regression equation was y = 0.94x+30.1 (R2 = 0.92; P<0.001). B For the semi-automated interactive software (P) with vessels, the regression equation was y = 1.00x+12.0 (R2 = 0.92; P<0.001). C For semi-automated interactive software (P) without vessels, the regression equation was y = 1.01x+28.0 (R2 = 0.92; P<0.001). Note: dotted curves mark the 95% confidence bands; linear regression analysis demonstrated a strong linear relationship between intraoperative weights and volumes with comparable results between the 3 different techniques.
Figure 3.
Blant-Altman Analysis for Inter-observer Agreement Regarding Volume of Transplanted Liver Segments.
A Manual commercial software (TR) with vessels. B Semi-automated interactive software (P) with vessels. C Semi-automated interactive software (P) without vessels. Note: straight lines define bias; dotted lines define 95% limits of agreement; the inter-observer agreement can be regarded as “good” for the 3 different techniques.
Table 3.
Intra-observer and Inter-observer Agreement of Volume of Transplanted Liver Segments.
Figure 4.
Manual Commercial Software (TR) – Image Example.
A Transverse image of the portal-venous phase – manual outline of the entire liver (yellow). B Transverse image of the portal-venous phase – manual outline of liver segments II/III (yellow). C Volume rendering (coronal view) resulting after manual outline of the entire liver. D Volume rendering (coronal view) resulting after manual outline of liver segments II/III. Note: in each live liver donor, CT-volumetry of the entire liver as well as of the future liver graft (transplanted liver segments) were performed to ensure that the postoperative liver volume is adequate.
Figure 5.
Semi-automated Interactive Software (P) – Image Example.
A Transverse image of the portal-venous phase – automated outline of the entire liver after manual correction of false-positive and false-negative extractions. B Manual positioning of the anatomical landmark “first bifurcation of the right portal vein” (blue circle) according to Fig. 1A. C Automated definition of segments of Couinaud for right liver - transverse image. D Automated definition of segments of Couinaud for left liver - sagittal image. E Volume rendering (coronal view) with automated definition of segments of Couinaud of the entire liver. F List of volumes for the different segments of Couinaud. G Transverse image of the portal-venous phase – automated outline of the entire liver after manual correction of false-positive and false-negative extractions. H Volume rendering (coronal view) with automated definition of vessels (liver veins in light blue and portal veins in dark blue). Note: in each live liver donor, CT-volumetry of the entire liver was performed to ensure that the postoperative liver volume, calculated on the basis of Fig. 5F, is adequate.