KLI

Liver-to-Spleen Volume Ratio Automatically Measured on CT Predicts Decompensation in Patients with B Viral Compensated Cirrhosis

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Abstract
Abstract
Objective: Although the liver-to-spleen volume ratio (LSVR) based on CT reflects portal hypertension, its prognostic role in cirrhotic patients has not been proven. We evaluated the utility of LSVR, automatically measured from CT images using a deep learning algorithm, as a predictor of hepatic decompensation and transplantation-free survival in patients with hepatitis B viral (HBV)-compensated cirrhosis.

Materials and methods: A deep learning algorithm was used to measure the LSVR in a cohort of 1027 consecutive patients (mean age, 50.5 years; 675 male and 352 female) with HBV-compensated cirrhosis who underwent liver CT (2007-2010). Associations of LSVR with hepatic decompensation and transplantation-free survival were evaluated using multivariable Cox proportional hazards and competing risk analyses, accounting for either the Child-Pugh score (CPS) or Model for End Stage Liver Disease (MELD) score and other variables. The risk of the liver-related events was estimated using Kaplan-Meier analysis and the Aalen-Johansen estimator.

Results: After adjustment for either CPS or MELD and other variables, LSVR was identified as a significant independent predictor of hepatic decompensation (hazard ratio for LSVR increase by 1, 0.71 and 0.68 for CPS and MELD models, respectively; p < 0.001) and transplantation-free survival (hazard ratio for LSVR increase by 1, 0.8 and 0.77, respectively; p < 0.001). Patients with an LSVR of < 2.9 (n = 381) had significantly higher 3-year risks of hepatic decompensation (16.7% vs. 2.5%, p < 0.001) and liver-related death or transplantation (10.0% vs. 1.1%, p < 0.001) than those with an LSVR ≥ 2.9 (n = 646). When patients were stratified according to CPS (Child-Pugh A vs. B-C) and MELD (< 10 vs. ≥ 10), an LSVR of < 2.9 was still associated with a higher risk of liver-related events than an LSVR of ≥ 2.9 for all Child-Pugh (p ≤ 0.045) and MELD (p ≤ 0.009) stratifications.

Conclusion: The LSVR measured on CT can predict hepatic decompensation and transplantation-free survival in patients with HBV-compensated cirrhosis
Author(s)
권지혜김강모김소연김호성석흥일성유섭윤지석이소정이승수이철민
Issued Date
2021
Type
Article
Keyword
End Stage Liver DiseaseFemaleHerpesvirus 1CeropithecineHumansLiver Cirrhosis - complicationsLiver Cirrhosis - diagnostic imagingMaleMiddle AgedRetrospective StudiesSpleenTomographyX-Ray Computed방사선과학
DOI
10.3348/kjr.2021.0348
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7431
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9887272&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Liver-to-Spleen%20Volume%20Ratio%20Automatically%20Measured%20on%20CT%20Predicts%20Decompensation%20in%20Patients%20with%20B%20Viral%20Compensated%20Cirrhosis&amp;offset=0&amp;pcAvailability=true
Publisher
KOREAN JOURNAL OF RADIOLOGY
Location
대한민국
Language
영어
ISSN
1229-6929
Citation Volume
22
Citation Number
12
Citation Start Page
1985
Citation End Page
1995
Appears in Collections:
Medicine > Medicine
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