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Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)
Background The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR). M...
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| Published in: | Abdominal imaging 2021-05, Vol.46 (5), p.1912-1921 |
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| container_end_page | 1921 |
| container_issue | 5 |
| container_start_page | 1912 |
| container_title | Abdominal imaging |
| container_volume | 46 |
| creator | Obmann, V. C. Marx, C. Hrycyk, J. Berzigotti, A. Ebner, L. Mertineit, N. Gräni, Ch Heverhagen, J. T. Christe, A. Huber, A. T. |
| description | Background
The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR).
Material and methods
Patients who underwent portal venous phase abdominal CT scans and MR elastography (reference standard) within 3 months between 02/2016 and 05/2017 were included. The LSVAR was calculated on portal venous CT scans as LSVR*LVCA, while the LSVR represented the volume ratio between Couinaud segments I-III and IV-VIII, and the LVCA represented the density of the liver veins compared to the density in the vena cava. The LSVAR and LSVR were compared between patients with and without significantly elevated liver stiffness (based on a cutoff value of 3.5 kPa) using the Mann–Whitney U test and ROC curve analysis.
Results
The LSVR and LSVAR allowed significant differentiation between patients with (
n
= 19) and without (
n
= 122) significantly elevated liver stiffness (
p
|
| doi_str_mv | 10.1007/s00261-020-02834-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8131336</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2528635957</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-f254c7b5b411e3a85611e8aa7cf519415dc5e143915fb9b08aa1c32e5447cfe73</originalsourceid><addsrcrecordid>eNp9UslqHDEQbUJMbBz_QA5BkIt96ERrL5eAGbLBQMB2Qm5Cra4ey6iljqQe8M_l26JZMk4c8EGUpHr16lXxiuIVwW8JxvW7iDGtSIkpzqdhvKyfFSeUVVWJsWieH-78x3FxFuMdxphUghAqXhTHjBFRtbw9KX4tzRoCirAawSVl0drbeQSkXI9USuBmlYx3KGwCOl9ef7-8ukD5Y_JhCwfn54gWNyhq5SIy4xT8GiJKt4B6SKC35X5A2hpntLL2HkWzcmbID5eQ3fYfTBd8NBFpP04qQI-S36f-k_Yg5eriZXE0KBvhbB9Pi28fP9wsPpfLr5--LC6XpeY1T-VABdd1JzpOCDDViCrHRqlaD4K0nIheCyCctUQMXdvhnCKaURCcZwjU7LR4v-Od5m6EXmdBQVk5BTOqcC-9MvLfjDO3cuXXsiGMMFZlgvM9QfA_Z4hJjiZqsFY5yAuUlIumphVtaYa-eQS983NweTxJBW0qJlqxUUR3KJ0XFwMMBzEEy41D5M4hMjtEbh0iN0Wv_x7jUPLHDxnAdoCYU24F4aH3E7S_AXE7yp0</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2528635957</pqid></control><display><type>article</type><title>Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)</title><source>Springer Nature</source><creator>Obmann, V. C. ; Marx, C. ; Hrycyk, J. ; Berzigotti, A. ; Ebner, L. ; Mertineit, N. ; Gräni, Ch ; Heverhagen, J. T. ; Christe, A. ; Huber, A. T.</creator><creatorcontrib>Obmann, V. C. ; Marx, C. ; Hrycyk, J. ; Berzigotti, A. ; Ebner, L. ; Mertineit, N. ; Gräni, Ch ; Heverhagen, J. T. ; Christe, A. ; Huber, A. T.</creatorcontrib><description>Background
The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR).
Material and methods
Patients who underwent portal venous phase abdominal CT scans and MR elastography (reference standard) within 3 months between 02/2016 and 05/2017 were included. The LSVAR was calculated on portal venous CT scans as LSVR*LVCA, while the LSVR represented the volume ratio between Couinaud segments I-III and IV-VIII, and the LVCA represented the density of the liver veins compared to the density in the vena cava. The LSVAR and LSVR were compared between patients with and without significantly elevated liver stiffness (based on a cutoff value of 3.5 kPa) using the Mann–Whitney U test and ROC curve analysis.
Results
The LSVR and LSVAR allowed significant differentiation between patients with (
n
= 19) and without (
n
= 122) significantly elevated liver stiffness (
p
< 0.001). However, the LSVAR showed a higher area under the curve (AUC = 0.96) than the LSVR (AUC = 0.74). The optimal cutoff value was 0.34 for the LSVR, which detected clinically increased liver stiffness with a sensitivity of 53% and a specificity of 88%. With a cutoff value of 0.67 for the LSVAR, the sensitivity increased to 95% while maintaining a specificity of 89%.
Conclusion
The LSVAR improves the detection of significant liver fibrosis on portal venous CT scans compared to the LSVR.</description><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-020-02834-7</identifier><identifier>PMID: 33156949</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Attenuation ; Clinical significance ; Computed tomography ; Density ; Fibrosis ; Gastroenterology ; Hepatobiliary ; Hepatology ; Imaging ; Liver ; Liver cirrhosis ; Medical diagnosis ; Medical imaging ; Medicine ; Medicine & Public Health ; Radiology ; Sensitivity ; Stiffness</subject><ispartof>Abdominal imaging, 2021-05, Vol.46 (5), p.1912-1921</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-f254c7b5b411e3a85611e8aa7cf519415dc5e143915fb9b08aa1c32e5447cfe73</citedby><cites>FETCH-LOGICAL-c474t-f254c7b5b411e3a85611e8aa7cf519415dc5e143915fb9b08aa1c32e5447cfe73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33156949$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Obmann, V. C.</creatorcontrib><creatorcontrib>Marx, C.</creatorcontrib><creatorcontrib>Hrycyk, J.</creatorcontrib><creatorcontrib>Berzigotti, A.</creatorcontrib><creatorcontrib>Ebner, L.</creatorcontrib><creatorcontrib>Mertineit, N.</creatorcontrib><creatorcontrib>Gräni, Ch</creatorcontrib><creatorcontrib>Heverhagen, J. T.</creatorcontrib><creatorcontrib>Christe, A.</creatorcontrib><creatorcontrib>Huber, A. T.</creatorcontrib><title>Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Background
The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR).
Material and methods
Patients who underwent portal venous phase abdominal CT scans and MR elastography (reference standard) within 3 months between 02/2016 and 05/2017 were included. The LSVAR was calculated on portal venous CT scans as LSVR*LVCA, while the LSVR represented the volume ratio between Couinaud segments I-III and IV-VIII, and the LVCA represented the density of the liver veins compared to the density in the vena cava. The LSVAR and LSVR were compared between patients with and without significantly elevated liver stiffness (based on a cutoff value of 3.5 kPa) using the Mann–Whitney U test and ROC curve analysis.
Results
The LSVR and LSVAR allowed significant differentiation between patients with (
n
= 19) and without (
n
= 122) significantly elevated liver stiffness (
p
< 0.001). However, the LSVAR showed a higher area under the curve (AUC = 0.96) than the LSVR (AUC = 0.74). The optimal cutoff value was 0.34 for the LSVR, which detected clinically increased liver stiffness with a sensitivity of 53% and a specificity of 88%. With a cutoff value of 0.67 for the LSVAR, the sensitivity increased to 95% while maintaining a specificity of 89%.
Conclusion
The LSVAR improves the detection of significant liver fibrosis on portal venous CT scans compared to the LSVR.</description><subject>Attenuation</subject><subject>Clinical significance</subject><subject>Computed tomography</subject><subject>Density</subject><subject>Fibrosis</subject><subject>Gastroenterology</subject><subject>Hepatobiliary</subject><subject>Hepatology</subject><subject>Imaging</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Radiology</subject><subject>Sensitivity</subject><subject>Stiffness</subject><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9UslqHDEQbUJMbBz_QA5BkIt96ERrL5eAGbLBQMB2Qm5Cra4ey6iljqQe8M_l26JZMk4c8EGUpHr16lXxiuIVwW8JxvW7iDGtSIkpzqdhvKyfFSeUVVWJsWieH-78x3FxFuMdxphUghAqXhTHjBFRtbw9KX4tzRoCirAawSVl0drbeQSkXI9USuBmlYx3KGwCOl9ef7-8ukD5Y_JhCwfn54gWNyhq5SIy4xT8GiJKt4B6SKC35X5A2hpntLL2HkWzcmbID5eQ3fYfTBd8NBFpP04qQI-S36f-k_Yg5eriZXE0KBvhbB9Pi28fP9wsPpfLr5--LC6XpeY1T-VABdd1JzpOCDDViCrHRqlaD4K0nIheCyCctUQMXdvhnCKaURCcZwjU7LR4v-Od5m6EXmdBQVk5BTOqcC-9MvLfjDO3cuXXsiGMMFZlgvM9QfA_Z4hJjiZqsFY5yAuUlIumphVtaYa-eQS983NweTxJBW0qJlqxUUR3KJ0XFwMMBzEEy41D5M4hMjtEbh0iN0Wv_x7jUPLHDxnAdoCYU24F4aH3E7S_AXE7yp0</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Obmann, V. C.</creator><creator>Marx, C.</creator><creator>Hrycyk, J.</creator><creator>Berzigotti, A.</creator><creator>Ebner, L.</creator><creator>Mertineit, N.</creator><creator>Gräni, Ch</creator><creator>Heverhagen, J. T.</creator><creator>Christe, A.</creator><creator>Huber, A. T.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210501</creationdate><title>Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)</title><author>Obmann, V. C. ; Marx, C. ; Hrycyk, J. ; Berzigotti, A. ; Ebner, L. ; Mertineit, N. ; Gräni, Ch ; Heverhagen, J. T. ; Christe, A. ; Huber, A. T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-f254c7b5b411e3a85611e8aa7cf519415dc5e143915fb9b08aa1c32e5447cfe73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Attenuation</topic><topic>Clinical significance</topic><topic>Computed tomography</topic><topic>Density</topic><topic>Fibrosis</topic><topic>Gastroenterology</topic><topic>Hepatobiliary</topic><topic>Hepatology</topic><topic>Imaging</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Medical diagnosis</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Radiology</topic><topic>Sensitivity</topic><topic>Stiffness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Obmann, V. C.</creatorcontrib><creatorcontrib>Marx, C.</creatorcontrib><creatorcontrib>Hrycyk, J.</creatorcontrib><creatorcontrib>Berzigotti, A.</creatorcontrib><creatorcontrib>Ebner, L.</creatorcontrib><creatorcontrib>Mertineit, N.</creatorcontrib><creatorcontrib>Gräni, Ch</creatorcontrib><creatorcontrib>Heverhagen, J. T.</creatorcontrib><creatorcontrib>Christe, A.</creatorcontrib><creatorcontrib>Huber, A. T.</creatorcontrib><collection>SpringerOpen</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer science database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Biological Science Journals</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Obmann, V. C.</au><au>Marx, C.</au><au>Hrycyk, J.</au><au>Berzigotti, A.</au><au>Ebner, L.</au><au>Mertineit, N.</au><au>Gräni, Ch</au><au>Heverhagen, J. T.</au><au>Christe, A.</au><au>Huber, A. T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR)</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>46</volume><issue>5</issue><spage>1912</spage><epage>1921</epage><pages>1912-1921</pages><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Background
The aim of this proof-of-concept study was to show that the liver segmental volume and attenuation ratio (LSVAR) improves the detection of significant liver fibrosis on portal venous CT scans by adding the liver vein to cava attenuation (LVCA) to the liver segmental volume ratio (LSVR).
Material and methods
Patients who underwent portal venous phase abdominal CT scans and MR elastography (reference standard) within 3 months between 02/2016 and 05/2017 were included. The LSVAR was calculated on portal venous CT scans as LSVR*LVCA, while the LSVR represented the volume ratio between Couinaud segments I-III and IV-VIII, and the LVCA represented the density of the liver veins compared to the density in the vena cava. The LSVAR and LSVR were compared between patients with and without significantly elevated liver stiffness (based on a cutoff value of 3.5 kPa) using the Mann–Whitney U test and ROC curve analysis.
Results
The LSVR and LSVAR allowed significant differentiation between patients with (
n
= 19) and without (
n
= 122) significantly elevated liver stiffness (
p
< 0.001). However, the LSVAR showed a higher area under the curve (AUC = 0.96) than the LSVR (AUC = 0.74). The optimal cutoff value was 0.34 for the LSVR, which detected clinically increased liver stiffness with a sensitivity of 53% and a specificity of 88%. With a cutoff value of 0.67 for the LSVAR, the sensitivity increased to 95% while maintaining a specificity of 89%.
Conclusion
The LSVAR improves the detection of significant liver fibrosis on portal venous CT scans compared to the LSVR.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33156949</pmid><doi>10.1007/s00261-020-02834-7</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2366-004X |
| ispartof | Abdominal imaging, 2021-05, Vol.46 (5), p.1912-1921 |
| issn | 2366-004X 2366-0058 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8131336 |
| source | Springer Nature |
| subjects | Attenuation Clinical significance Computed tomography Density Fibrosis Gastroenterology Hepatobiliary Hepatology Imaging Liver Liver cirrhosis Medical diagnosis Medical imaging Medicine Medicine & Public Health Radiology Sensitivity Stiffness |
| title | Liver segmental volume and attenuation ratio (LSVAR) on portal venous CT scans improves the detection of clinically significant liver fibrosis compared to liver segmental volume ratio (LSVR) |
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