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Computed tomography-based measurements of normative liver and spleen volumes in children

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Abstract

Background

Quantification of organ size has utility in clinical care and research for diagnostics, prognostics and surgical planning. Volumetry is regarded as the best measure of organ size and change in size over time. Scarce reference values exist for liver and spleen volumes in healthy children.

Objective

To report liver and spleen volumes for a sample of children defined by manual segmentation of contrast-enhanced CT images with the goal of defining normal values and thresholds that might indicate disease.

Materials and methods

This retrospective study included clinically acquired contrast-enhanced CTs of the abdomen/pelvis for children and adolescents imaged between January 2018 and July 2021. Liver and spleen volumes were derived through manual segmentation of CTs reconstructed at 2.5-, 3- or 5-mm slice thickness. A subset of images (5%, n=16) was also segmented using 0.5-mm slice thickness reconstructions to define agreement based on image slice thickness. We used Pearson correlation and multivariable regression to assess associations between organ volumes and patient characteristics. We generated reference intervals for the 5th, 25th, 50th (median), 75th and 95th percentiles for organ volumes as a function of age and weight using quantile regression models. Finally, we calculated Bland–Altman plots and intraclass correlation coefficients (ICC) to quantify agreement.

Results

We included a total of 320 children (mean age ± standard deviation [SD] = 9±4.6 years; mean weight 38.1±18.8 kg; 160 female). Liver volume ranged from 340–2,002 mL, and spleen volume ranged from 28–480 mL. Patient weight (kg) (β=12.5), age (months) (β=1.7) and sex (female) (β = −35.3) were independent predictors of liver volume, whereas patient weight (kg) (β=2.4) and age (months) (β=0.3) were independent predictors of spleen volume. There was excellent absolute agreement (ICC=0.99) and minimal absolute difference (4 mL) in organ volumes based on reconstructed slice thickness.

Conclusion

We report reference liver and spleen volumes for children without liver or spleen disease. These results provide reference ranges and potential thresholds to identify liver and spleen size abnormalities that might reflect disease in children.

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Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., Kasota Building MLC 5031, Cincinnati, OH, 45229, USA

    Vinicius de Padua V. Alves, Jonathan R. Dillman, Elanchezhian Somasundaram, Zachary P. Taylor, Samuel L. Brady & Andrew T. Trout

  2. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Jonathan R. Dillman, Samuel L. Brady & Andrew T. Trout

  3. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Bin Zhang

  4. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Bin Zhang & Andrew T. Trout

Authors
  1. Vinicius de Padua V. Alves
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  2. Jonathan R. Dillman
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  3. Elanchezhian Somasundaram
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  4. Zachary P. Taylor
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  6. Bin Zhang
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Correspondence to Andrew T. Trout.

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de Padua V. Alves, V., Dillman, J.R., Somasundaram, E. et al. Computed tomography-based measurements of normative liver and spleen volumes in children. Pediatr Radiol 53, 378–386 (2023). https://doi.org/10.1007/s00247-022-05551-z

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  • DOI: https://doi.org/10.1007/s00247-022-05551-z

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