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Liver volume is a prognostic indicator for clinical outcome of patients with alcoholic hepatitis

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Abstract

Purpose

To evaluate the prognostic value of abdominal computed tomography (CT) in patients with alcoholic hepatitis (AH).

Methods

This ancillary study was based on data collected during a previous randomized controlled trial in patients with AH. Clinical response was defined as the improvement of the baseline MELD score ≥3 points at 3 months. All patients underwent contrast-enhanced CT of the abdomen. The following parameters were measured: (1) liver density, spleen density, and liver-to-spleen density ratio; (2) liver-to-body weight (LBW) ratio; and (3) subcutaneous fat, visceral fat, and muscular content. Improvers and non-improvers were compared with univariate, multivariate, and ROC analyses. Results were compared with a validation cohort of patients.

Results

Fifty-eight patients (mean age, 56 years) were analyzed, including 34 (59 %) improvers. On multivariate analysis, LBW ratio (OR = 3.73; 95 % CI, 1.65–8.46; p = 0.002) and subcutaneous fat (OR = 1.01; 95 % CI, 1.00–1.02; p = 0.022) were associated with clinical response, with AUROC curves of 0.78 ± 0.06 (p < 0.001) and 0.66 ± 0.07 (p = 0.043), respectively. LBW ≥2.4 % predicted response with 88 % sensitivity and 63 % specificity. In the validation cohort (n = 42, 64 % improvers), the same cut-off value predicted response with 93 % sensitivity and 60 % specificity.

Conclusions

In patients suffering from AH, the liver volume appears to be a major positive prognostic factor.

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Abbreviations

AH:

Alcoholic hepatitis

ASH:

Alcoholic steatohepatitis

AUROC:

Area under the receiver-operator characteristic curve

CI:

Confidence intervals

CT:

Computed tomography

LBW:

Liver-to-body weight

MRI:

Magnetic resonance imaging

OR:

Odds ratio

ROI:

Region of interest

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Author information

Authors and Affiliations

  1. Department of Radiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland

    Romain Breguet, Maxime Ronot, Catrina Hansen, Christoph D. Becker & Sylvain Terraz

  2. Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland

    Romain Breguet, Nicolas Goossens, Catrina Hansen, Emiliano Giostra, Pietro Majno, Christoph D. Becker, Laurent Spahr & Sylvain Terraz

  3. Department of Radiology, University Hospitals of Beaujon, Paris, France

    Romain Breguet & Maxime Ronot

  4. Department of Gastroenterology and Hepatology, University Hospitals of Geneva, Geneva, Switzerland

    Nicolas Goossens, Emiliano Giostra & Laurent Spahr

  5. Department of Visceral Surgery, University Hospitals of Geneva, Geneva, Switzerland

    Pietro Majno

Authors
  1. Romain Breguet
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  2. Maxime Ronot
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  3. Nicolas Goossens
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  4. Catrina Hansen
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  5. Emiliano Giostra
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  6. Pietro Majno
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  7. Christoph D. Becker
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  8. Laurent Spahr
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  9. Sylvain Terraz
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Corresponding author

Correspondence to Sylvain Terraz.

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Funding

This study has been financially supported by the Clinical Research Center, University Hospital and Faculty of Medicine, Geneva, and the Louis-Jeantet Foundation, and FLAGS (Foundation for Liver and Gut Studies in Geneva), and la Loterie Romande. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Breguet, R., Ronot, M., Goossens, N. et al. Liver volume is a prognostic indicator for clinical outcome of patients with alcoholic hepatitis. Abdom Radiol 42, 460–467 (2017). https://doi.org/10.1007/s00261-016-0892-7

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  • DOI: https://doi.org/10.1007/s00261-016-0892-7

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