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Comparative Study
, 197 (4), W706-12

Quantitative Radiology: Automated CT Liver Volumetry Compared With Interactive Volumetry and Manual Volumetry

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Comparative Study

Quantitative Radiology: Automated CT Liver Volumetry Compared With Interactive Volumetry and Manual Volumetry

Kenji Suzuki et al. AJR Am J Roentgenol.

Abstract

Objective: The purpose of this study was to evaluate automated CT volumetry in the assessment of living-donor livers for transplant and to compare this technique with software-aided interactive volumetry and manual volumetry.

Materials and methods: Hepatic CT scans of 18 consecutively registered prospective liver donors were obtained under a liver transplant protocol. Automated liver volumetry was developed on the basis of 3D active-contour segmentation. To establish reference standard liver volumes, a radiologist manually traced the contour of the liver on each CT slice. We compared the results obtained with automated and interactive volumetry with those obtained with the reference standard for this study, manual volumetry.

Results: The average interactive liver volume was 1553 ± 343 cm(3), and the average automated liver volume was 1520 ± 378 cm(3). The average manual volume was 1486 ± 343 cm(3). Both interactive and automated volumetric results had excellent agreement with manual volumetric results (intraclass correlation coefficients, 0.96 and 0.94). The average user time for automated volumetry was 0.57 ± 0.06 min/case, whereas those for interactive and manual volumetry were 27.3 ± 4.6 and 39.4 ± 5.5 min/case, the difference being statistically significant (p < 0.05).

Conclusion: Both interactive and automated volumetry are accurate for measuring liver volume with CT, but automated volumetry is substantially more efficient.

Figures

Fig. 1
Fig. 1
Flowchart shows automated volumetry scheme for liver CT based on 3D anisotropic diffusion smoothing, 3D scale-specific edge enhancement, and 3D geodesic active contour liver extraction.
Fig. 2
Fig. 2
47-year-old woman. Examples of resulting image at each step in automated volumetry scheme. A, Original axial CT image of liver. B, Three-dimensional anisotropic diffusion noise reduction. C, Three-dimensional scale-specific gradient magnitude calculation. D, Three-dimensional geodesic active-contour segmentation.
Fig. 3
Fig. 3
Relations between interactive or automated volumetry and manual volumetry, which was reference standard for this study. Each volumetric method reached excellent agreement with reference standard (intraclass correlation coefficient, 0.96 and 0.94 for interactive and automated methods). A, Graph shows volume measured with interactive method versus that obtained with manual method. B, Graph shows volume measured with automated method versus that obtained with manual method.
Fig. 4
Fig. 4
Bland-Altman plots for agreement between manual volumetry and interactive or automated volumetry. A, Plot for interactive and manual volumetry. B, Plot for automated and manual volumetry.
Fig. 5
Fig. 5
49-year-old man. CT images show liver area determined with three volumetric methods. A, Original axial image of liver. B, Reference standard manually-traced liver contour (red). C, Liver area determined with interactive volumetry entailing use of software aid (purple). D, Liver area determined with automated method (yellow).

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