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

Objectives: Our objective was to assess the accuracy of computed tomography volumetry in estimating liver volume in steatotic patients. Materials and Methods: 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] x 100. We obtained estimation errors, intraclass correlation coefficients, and Pearson correlation coefficients across the groups. Results: Baseline alanine aminotransferase and gamma-glutamyltranspeptidase values were significantly 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). Conclusions: Preoperative computed tomography volumetry is an accurate tool for estimating volume regardless of the extent of steatosis.