LAUSR

H. C. Yu, S. W. Ahn and J. D. Yang Surgery, Chonbuk National University Medical School, Republic of Korea Background: Manual tracing of the right and left liver lobes from computed tomography (CT) images for graft volumetry in preoperative surgery planning of living donor liver transplantation (LDLT) is common at most medical centers. This study aims to develop a highly automatic system with advanced image processing algorithms and user-friendly interfaces for liver graft volumetry and evaluate its accuracy and efficiency through comparison to the manual tracing method. Methods: The proposed system provides a sequential procedure consisting of (1) liver segmentation, (2) blood vessel segmentation, and (3) virtual liver resection for liver graft volumetry. The proposed system was evaluated using 50 CT datasets in terms of graft weight estimation accuracy and task completion time through comparison to the manual tracing method. Results: The proposed system showed significantly higher accuracy and efficiency in liver graft weight estimation (AD = 21.0 18.4 g; %AD = 3.1% 2.8%; percentage of %AD > 10% = none; task completion time = 7.3 1.4 min) than the manual tracing method (AD = 70.5 52.1 g; %AD = 10.2% 7.5%; percentage of %AD> 10% = 46%; task completion time = 37.9 7.0 min). The proposed system showed slightly higher intraand inter-observer agreements (ICC = 0.996 to 0.998) in liver graft weight estimation than the manual tracing method (ICC = 0.979 to 0.999). Conclusions: The proposed system was proved accurate and efficient in liver graft volumetry for preoperative planning of LDLT.