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Kutaiba N, Chung W, Goodwin M, Testro A, Egan G, Lim R. The impact of hepatic and splenic volumetric assessment in imaging for chronic liver disease: a narrative review. Insights Imaging 2024; 15:146. [PMID: 38886297 PMCID: PMC11183036 DOI: 10.1186/s13244-024-01727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 05/26/2024] [Indexed: 06/20/2024] Open
Abstract
Chronic liver disease is responsible for significant morbidity and mortality worldwide. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) can fully visualise the liver and adjacent structures in the upper abdomen providing a reproducible assessment of the liver and biliary system and can detect features of portal hypertension. Subjective interpretation of CT and MRI in the assessment of liver parenchyma for early and advanced stages of fibrosis (pre-cirrhosis), as well as severity of portal hypertension, is limited. Quantitative and reproducible measurements of hepatic and splenic volumes have been shown to correlate with fibrosis staging, clinical outcomes, and mortality. In this review, we will explore the role of volumetric measurements in relation to diagnosis, assessment of severity and prediction of outcomes in chronic liver disease patients. We conclude that volumetric analysis of the liver and spleen can provide important information in such patients, has the potential to stratify patients' stage of hepatic fibrosis and disease severity, and can provide critical prognostic information. CRITICAL RELEVANCE STATEMENT: This review highlights the role of volumetric measurements of the liver and spleen using CT and MRI in relation to diagnosis, assessment of severity, and prediction of outcomes in chronic liver disease patients. KEY POINTS: Volumetry of the liver and spleen using CT and MRI correlates with hepatic fibrosis stages and cirrhosis. Volumetric measurements correlate with chronic liver disease outcomes. Fully automated methods for volumetry are required for implementation into routine clinical practice.
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Affiliation(s)
- Numan Kutaiba
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia.
- The University of Melbourne, Parkville, Melbourne, VIC, Australia.
| | - William Chung
- The University of Melbourne, Parkville, Melbourne, VIC, Australia
- Department of Gastroenterology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Mark Goodwin
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
- The University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Adam Testro
- The University of Melbourne, Parkville, Melbourne, VIC, Australia
- Department of Gastroenterology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Gary Egan
- Monash Biomedical Imaging, Monash University, Clayton, VIC, 3800, Australia
| | - Ruth Lim
- Department of Radiology, Austin Health, 145 Studley Road, Heidelberg, VIC, 3084, Australia
- The University of Melbourne, Parkville, Melbourne, VIC, Australia
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Muacevic A, Adler JR, Zidan M, Elgyoum A, Hassan H, Abdelrahman O. Estimation of Spleen Volume Using MRI Segmentation: Would One Slice Be Enough? Cureus 2022; 14:e32165. [PMID: 36601193 PMCID: PMC9806286 DOI: 10.7759/cureus.32165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/07/2022] Open
Abstract
This study aimed to establish spleen volume in adult Sudanese using manual segmentation and the Cavalieri method with magnetic resonance images (MRI). A total of 345 abdominal MRI scans for adults were retrospectively studied for patients who underwent abdomen MRI between September to October 2016. The data were collected from two scanning centers in Khartoum, Sudan. For each series of sectional images, the spleen was manually segmented, and the volume was calculated using matrix laboratory (MATLAB) code. Furthermore, abdominal circumferences and diameters, in addition to L1 body dimension and spinal canal, were measured. The mean splenic volume in our study was 187.2 cm3, without a significant change with age (P = 0.269). The average volume in males was 223.5 cm3 while in females it was 170.27 cm3. The average coefficient error (CE) was 0.029. A positive significant correlation was found between the volume and spleen length (beta standardized coefficient = 0.781, P < 0.05). The mean length was 9.18 cm. Additionally, our data showed an insignificant correlation between the volume and the other measurements, except for the abdomen transverse diameter (beta standardized coefficient = 0.267, P < 0.05). The results of our study coincided with previous studies in the normal range of spleen volume and the strong correlation with length, regardless of the irregular shape of the spleen. In addition, manual segmentation was a reliable method to measure spleen volume objectively. However, our single-slice measurements were insufficient.
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Bouferraa Y, Haibe Y, Jabra E, Charafeddine M, Kreidieh M, Raad R, Temraz S, Mukherji D, Ershaid F, Muallem N, Faraj W, Khalife M, Eid RA, Shamseddine A. Comparison Between Liver Stiffness Measurement by Fibroscan and Splenic Volume Index as NonInvasive Tools for the Early Detection of Oxaliplatin-induced Hepatotoxicity. J Clin Exp Hepatol 2022; 12:448-453. [PMID: 35535062 PMCID: PMC9077221 DOI: 10.1016/j.jceh.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/05/2021] [Indexed: 12/12/2022] Open
Abstract
Background Oxaliplatin remains an essential component of many chemotherapy protocols for gastrointestinal cancers; however, neurotoxicity and hepatotoxicity may be dose-limiting. The gold standard for the diagnosis of oxaliplatin-induced hepatotoxicity is liver biopsy, which is invasive and costly. Splenomegaly has also been used as a surrogate for liver biopsy in detecting oxaliplatin-induced sinusoidal obstruction syndrome (SOS), but splenic measurement is not routine and can be inaccurate and complex. We investigated the correlation between increased liver elasticity assessed by Fibroscan and the increase in spleen volume on cross-sectional imaging after oxaliplatin as a noninvasive technique to assess liver stiffness associated with oxaliplatin-induced SOS. Methods Forty-six patients diagnosed with gastrointestinal cancers and planned to take oxaliplatin containing regimens were included in this prospective study at the American University of Beirut Medical Center (AUBMC). Measurement of spleen volume using cross-sectional imaging and of liver elasticity using Fibroscan was performed at baseline, 3 and 6 months after starting oxaliplatin. Mean liver elasticity measurements were compared between patients stratified by the development of splenomegaly using the Student t-test. Splenomegaly was defined as 50% increase in spleen size compared with baseline. Results Patients who developed splenomegaly after oxaliplatin use had significantly higher mean elasticity measurements as reported by Fibroscan at 3 (16.2 vs. 7.8 kPa, P = 0.036) and 6 (9.3 vs. 6.7 kPa, P = 0.03) months. Conclusion Measurement of elasticity using Fibroscan could be potentially used in the future as a noninvasive test for predicting oxaliplatin-induced hepatotoxicity.
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Key Words
- AUBMC, American University of Beirut Medical Center
- CAP, Controlled attenuation parameter
- CT, Computed tomography
- ECOG, Eastern Cooperative Clinical Oncology Group
- ICG-R15, indocyanine green retention rate at 15 min (ICG-R15)
- IRB, Institutional review board
- ISP, IntelliSpace Portal
- MRI, Magnetic resonance imaging
- SOS, Sinusoidal obstruction syndrome
- SV, Splenic volume
- SVI, Splenic volume index
- TE, Transient elastography
- dB/m, decibels/meter
- fibroscan
- hepatotoxicity
- kPa, Kilopascal
- oxalipltin
- sinusoidal obstruction syndrome
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Affiliation(s)
- Youssef Bouferraa
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Yolla Haibe
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Elio Jabra
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Maya Charafeddine
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Malek Kreidieh
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Randa Raad
- Department of Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Sally Temraz
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Firas Ershaid
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Nadim Muallem
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Walid Faraj
- Department of Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Mohamad Khalife
- Department of Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Rania A. Eid
- Department of Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Ali Shamseddine
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon,Address for correspondence: Professor Ali Shamseddine, Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut, 1107 2020, Lebanon.
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Demissie S, Mergu P, Hailu T, Abebe G, Warsa M, Fikadu T. Morphometric assessment of spleen dimensions and its determinants among individuals living in Arba Minch town, southern Ethiopia. BMC Med Imaging 2021; 21:186. [PMID: 34863114 PMCID: PMC8642847 DOI: 10.1186/s12880-021-00719-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 11/19/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction The spleen is a vital lymphoid soft organ that demands constant attention from the clinical point of view. It is a multi-dimensional organ that enlarges in its all dimensions during some disease condition. The detection of the spleen by palpation is not an indicator of an enlarged spleen because normal spleen may be palpable. Therefore, this study aimed to assess the morphometry of spleen dimensions and its determinants among individuals living in Arba Minch town by sonographic examinations. Methods and materials Community-based cross-sectional study was conducted in Arba Minch town from February 1 to March 30, 2020. Seven hundred and eight study participants were selected using a multi-stage systematic random sampling technique. Data were checked for completeness, edited, coded and entered into Epi-Data version 3.1 and exported to STATA software version 16 for analysis. Result The mean splenic length, width, thickness and volume were 10.24 cm, 4.79 cm, 3.93 cm, and 109.34 cm3, respectively. The mean spleen length, width, thickness and volumes among males were 10.64 cm, 4.92 cm, 4.05 cm and 119.81 cm3 and among females were 9.75 cm, 4.63 cm, 3.78 cm and 96.50 cm3 respectively. As age increased by one year the mean spleen length, width, thickness and volume was decreased by 0.032 cm, 0.018 cm 0.004 cm and 0.012 cm respectively. As height increased by 1 cm the mean spleen width and volume were increased by 0.096 cm and 0.052 cm respectively. As we go from male to female the mean spleen length decreased by 0.294 cm. Conclusion The spleen dimensions were higher in males than females. Splenic length was determined by age & sex, the spleen width was determined by age & height, the spleen volume was determined by age & height and the spleen thickness was determined by age.
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Affiliation(s)
- Solomon Demissie
- Department of Clinical Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
| | - Prasad Mergu
- Department of Anatomy, MNR Medical College and Hospital, Sagerddy, Telangana, India
| | - Tadiwos Hailu
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Getachew Abebe
- Department of Clinical Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Mengistu Warsa
- Department of Medicine, Arba Minch General Hospital, Arba Minch, Ethiopia
| | - Teshale Fikadu
- Department of Public Health and Epidemiology, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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El Chediak A, Haydar AA, Hakim A, Massih SA, Hilal L, Mukherji D, Temraz S, Shamseddine A. Increase in spleen volume as a predictor of oxaliplatin toxicity. Ther Clin Risk Manag 2018; 14:653-657. [PMID: 29695909 PMCID: PMC5905497 DOI: 10.2147/tcrm.s150968] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Oxaliplatin is a nonconventional third-generation platinum compound. It is an important chemotherapeutic agent in regimens used in gastrointestinal carcinomas as well as other malignancies. Oxaliplatin toxicity profile includes neurotoxicity, hepatotoxicity, and splenomegaly. The primary aim of this study was to measure the spleen volume of patients on oxaliplatin therapy before and during chemotherapy to detect any increase in splenic size as a biomarker for early oxaliplatin toxicity. Methods This was a prospective pilot study conducted at the American University of Beirut-Medical Center. Fifty patients newly started on oxaliplatin were included. The spleen volume was measured from the patients’ baseline CT scan using the IntelliSpace Portal upgraded system (using Response Evaluation Criteria In Solid Tumors [RECIST]), for each follow-up CT scan. Side effects were evaluated at each patient visit and graded according to the severity. Results Thirty-seven (74%) patients developed an increase in spleen size. Thirty-three (66%) sampled patients developed peripheral neuropathy (all grades) at 3 months, whereas only two (4%) patients developed grade 3 neuropathy. Only one (3%) patient who developed an increase in spleen size also developed grade 3 peripheral neuropathy – a result that is significantly different (p<0.001) when comparing patients with an increase in spleen size who also developed peripheral neuropathy of other grades. Conclusion An increase in spleen volume possibly precedes a significant peripheral neuropathy which could be a potential marker for oxaliplatin-induced toxicity.
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Affiliation(s)
- Alissar El Chediak
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Ali A Haydar
- Department of Diagnostic Radiology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Ayman Hakim
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Sarah Abdel Massih
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Lara Hilal
- Department of Radiation Oncology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Sally Temraz
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut-Medical Center, Beirut, Lebanon
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Sangeeta M, Varalakshmi KL, Sahana BN. Cadaveric Study of Morphometry of Spleen. JOURNAL OF MEDICAL SCIENCES AND HEALTH 2015. [DOI: 10.46347/jmsh.2015.v01i03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Badran DH, Kalbouneh HM, Al-Hadidi MT, Shatarat AT, Tarawneh ES, Hadidy AM, Mahafza WS. Ultrasonographic assessment of splenic volume and its correlation with body parameters in a Jordanian population. Saudi Med J 2015; 36:967-72. [PMID: 26219448 PMCID: PMC4549594 DOI: 10.15537/smj.2015.8.11809] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/26/2015] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To estimate normal linear dimensions and volume of spleen in Jordanians using ultrasonography, and to correlate splenic volume with age and body parameters: height, weight, body surface area (BSA), and body mass index (BMI). METHODS A prospective pilot study was conducted on 205 volunteers (115 males and 90 females) not known to have any conditions likely to be associated with splenomegaly. The study was performed at the Radiology Department, Jordanian University Hospital, Amman, Jordan, between December 2013 and August 2014. All linear dimensions of spleen were measured, and splenic volume (index) was calculated using the standard prolate ellipsoid formula (length × width × depth × 0.523). The splenic volume was then analyzed with age and body parameters using the Pearson's correlation coefficient. RESULTS The mean (± SD) splenic dimensions were 10.72±1.37 cm in length, 7.40±1.52 cm in width, 4.40±1.47 cm in depth, and 184.15±79.56 cm3 in volume. Men had larger spleens than women (p less than 0.0001). Age had no significant effect on spleen volume (r=0.11, p=0.12). There was a significant moderate positive correlation (p less than 0.0001), using Pearson's correlation coefficient, between the spleen volume, and other parameters (height, weight, BSA, and BMI), with correlation coefficients exceeding 0.3. CONCLUSION A local reference of spleen dimensions was established with a different range of values reported previously.
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Affiliation(s)
- Darwish H Badran
- Department of Anatomy and Histology, Faculty of Medicine, University of Jordan, Amman, Jordan. E-mail.
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Studer AS, Kahn CJF, Bege T, Thollon L, Loundou A, Chaumoître K, Coze S, Berdah S, Brunet C. An anatomic and morphometric analysis of splenic variability using 3D reconstruction and spatial orientation from computed tomography. Ann Anat 2015. [PMID: 26204553 DOI: 10.1016/j.aanat.2015.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In terms of frequency, the spleen is the first organ affected in abdominal trauma, resulting even today in a high rate of mortality (10%). Nevertheless, very few studies have investigated splenic quantitative morphometry as to shape and spatial orientation. Therefore, we analysed healthy spleen variability in order to integrate it in its environment and to correlate its morphometric parameters to anthropometric characteristics. METHODS Ninety abdominopelvic CT-scans performed on patients over 16 years with no splenic pathology were retrospectively selected among a Mediterranean population. Three age groups ([16-30], [30-60] and [over 60 years]), equally distributed among genders, were created. Parameters, such as volume, characteristic checkpoints, orientation, and morphology, were measured on the spleen, the 11th thoracic vertebra and the 10th ribs in three-dimensional reconstructions. Anthropometric parameters were characterised by waist circumference, costo-xiphoid angle, abdominal height and chest depth. RESULTS Observed variations in splenic morphology were divided into three groups: cupped (66.7%), coiled (17.8%), and flat (15.5%). Splenic morphometry tends to be abdominal-shaped (54.5%) or dorsal-shaped (45.5%). The mean of the angle between the main axis of the spleen and the CT-scan horizontal axis was 40±14°. Correlations were highlighted between volume and gender (p<0.05), splenic morphology and liver morphometry (p<0.05) as well as between orientation of hilar surface and splenic morphometry (p<0.01). Moreover, the spleen is more horizontal in women (p<0.05), in the elderly (p<0.05) and in the obese (p<0.01). CONCLUSION This study defines three groups based on shape and highlights correlations between parameters describing healthy splenic variability and its anthropometric characteristics, which are of great importance for numerical modelling in splenic studies.
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Affiliation(s)
- A-S Studer
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France.
| | - C J F Kahn
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France
| | - T Bege
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France
| | - L Thollon
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France
| | - A Loundou
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; Department of Public Health and Biostatistics, Faculty of Medicine, Aix Marseille University, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - K Chaumoître
- AP-HM, Department of Imaging and Interventional Radiology, North Hospital, Marseille, France
| | - S Coze
- AP-HM, Department of Imaging and Interventional Radiology, North Hospital, Marseille, France
| | - S Berdah
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France
| | - C Brunet
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France
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Raza Siddiqui T, Hassan N, Gul P. Effect of anthropometrical measurements on portal vein and hepatosplenic span. Pak J Med Sci 2013; 29:1077-80. [PMID: 24353693 PMCID: PMC3817760 DOI: 10.12669/pjms.294.3617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/03/2013] [Accepted: 05/23/2013] [Indexed: 11/02/2022] Open
Affiliation(s)
- Tanya Raza Siddiqui
- Dr. Tanya Raza Siddiqui, MBBS, M. Phil Candidate, Senior Lecturer, Department of Anatomy, Ziauddin Hospital, Karachi, Pakistan
| | - Nuzhat Hassan
- Dr. Nuzhat Hassan, M.phil- Anatomy, Head of Department of Anatomy, Ziauddin Hospital, Karachi, Pakistan
| | - Pashmina Gul
- Dr. Pashmina Gul, FCPS, Assistant Professor, Department of Radiology, Ziauddin Hospital, Karachi, Pakistan
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