Published online Oct 28, 2016. doi: 10.3748/wjg.v22.i40.8949
Peer-review started: June 28, 2016
First decision: August 22, 2016
Revised: September 2, 2016
Accepted: September 28, 2016
Article in press: September 28, 2016
Published online: October 28, 2016
To evaluate the diagnostic performance of computed tomography (CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD).
A total of 38 NAFLD patients were enrolled. On the basis of CT imaging, the volumes of total, left lateral segment (LLS), left medial segment, caudate lobe, and right lobe (RL) of the liver were calculated with a dedicated liver application. The relationship between the volume percentage of each area and fibrosis stage was analyzed using Spearman’s rank correlation coefficient. A receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of CT volumetry for discriminating fibrosis stage.
The volume percentages of the caudate lobe and the LLS significantly increased with the fibrosis stage (r = 0.815, P < 0.001; and r = 0.465, P = 0.003, respectively). Contrarily, the volume percentage of the RL significantly decreased with fibrosis stage (r = -0.563, P < 0.001). The volume percentage of the caudate lobe had the best diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating fibrosis stage were as follows: ≥ F1, 0.896; ≥ F2, 0.929; ≥ F3, 0.955; and ≥ F4, 0.923. The best cut-off for advanced fibrosis (F3-F4) was 4.789%, 85.7% sensitivity and 94.1% specificity.
The volume percentage of the caudate lobe calculated by CT volumetry is a useful diagnostic parameter for staging fibrosis in NAFLD patients.
Core tip: This is a retrospective study to elucidate the morphological change in nonalcoholic fatty liver disease (NAFLD) using computed tomography (CT) volumetry and to evaluate the diagnostic performance of CT volumetry for discriminating the fibrosis stage in NAFLD. The volume percentages of the caudate lobe calculated by CT volumetry were significantly increased with the increase in fibrosis stage in NAFLD. The volume percentage of the caudate lobe is a useful diagnostic parameter for staging fibrosis in patients with NAFLD. The evaluation of liver volume using CT volumetry is useful for predicting the fibrosis stage in NAFLD.