Role of Computed Tomography Volumetry in Estimating Liver Weights in Surgical Patients with Hepatic Steatosis

Our objective was to assess the accuracy of computed tomography volumetry in estimating liver volume in steatotic patients. We divided 641 liver donors (mean age 27 years, 71% male) into 4 groups according to the extent of steatosis on predonation biopsy: with < 5% comprising group 1, 5% to 9% comprising group 2, 10% to 19% comprising group 3, and ≥ 20% comprising group 4. Graft mass estimation error (%) was calculated as follows: [(computed tomography-measured volume minus graft weight)/graft weight] × 100. We obtained estimation errors, intraclass correlation coefficients, and Pearson correlation coefficients across the groups. Baseline alanine aminotransferase and gammaglutamyltranspeptidase values were signi ficantly correlated with extent of steatosis. Mean graft weight and computed tomography-measured volume were 725.9 g and 741.2 mL. Mean estimation errors were comparable (1.5% for group 1, 2.7% for group 2, 3.0% for group 3, and 3.9% for group 4; P = .77). In multivariate linear regression, estimation error was inversely correlated with high-density lipoprotein cholesterol (P = .008). Overall, there was an excellent agreement between measured volume and actual weight, with intraclass correlation coefficients over 0.85 and Pearson correlation coefficients over 0.70 in all groups (P < .001). Preoperative computed tomography volumetry is an accurate tool for estimating volume regardless of the extent of steatosis.