Point-shear wave elastography predicts liver hypertrophy after portal vein embolization and postoperative liver failure

Purpose: To correlate point-shear wave elastography (SWE) with liver hypertrophy after right portal vein embolization (RPVE) and to determine its usefulness in predicting postoperative liver failure in patients undergoing partial liver resection. Patients and methods: Point-SWE was performed the day before RPVE in 56 patients (41 men) with a median age of 66 years. The percentage (%) of future remnant liver (FRL) volume increase was defined as: (%FRLpost-%FRLpre/%FRLpre) 100 and assessed on computed tomography performed 4 weeks after RPVE. Results: Median (range) %FRLpre and %FRL(pos)t was respectively, 31.5% (12-48%) and 41% (23-61%) (P<0.001), with a median %FRL volume increase of 25.6% (-8; 123%). SWE correlated with %FRL volume increase (P= -0.510; P <0.001). SWV (P= 0.003) and %FRLpre (P<0.001) were associated with %FRL volume increase at multivariate regression analysis. Forty-three patients (77%) were operated. Postoperative liver failure occurred in 14 patients (32.5%). Median SWE was different between the group with (1.68 m/s) and without liver failure (1.07 m/s) (P= 0.018). The AUROC of SWE predicting liver failure was 0.724 with a best cut-off of 1.31 m/s, corresponding to a sensitivity of 21%, specificity of 96%, positive predictive value 75% and negative predictive value of 72%. SWE was the single independent preoperative variable associated with liver failure. Conclusions: SWE assessed by point-SWE is a simple and useful tool to predict the FRL volume increase and postoperative liver failure in a population of patients with liver tumor. (C) 2018 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.