Comparative evaluation of volumetry estimation from plain and contrast enhanced computed tomography liver images.

Objectives: Surgery planning for liver tumour is carried out using contrast enhanced computed tomography (CECT) images to determine the optimal resection strategy and to assess the volume of liver and tumour. Current surgery planning tools interpret even the functioning liver cells present within the tumour boundary as tumour. Plain CT images provide inadequate information for treatment planning. This work attempts to address two shortcomings of existing surgery planning tools: (i) to delineate functioning liver cells from the non-functioning tumourous tissues within the tumour boundary and (ii) to provide 3D visualization and actual tumour volume from the plain CT images.

Methods: All slices of plain CT images containing liver are enhanced by means of fuzzy histogram equalization in Non-Subsampled Contourlet Transform (NSCT) domain prior to 3D reconstruction to clearly delineate liver, non-functioning tumourous tissues and functioning liver cells within the tumour boundary. The 3D analysis from plain and CECT images was carried out on five types of liver lesions viz. HCC, metastasis, hemangioma, cyst, and abscess along with normal liver.

Results: The study resulted in clear delineation of functional liver tissues from non-functioning tumourous tissues within the tumour boundary from CECT as well as plain CT images. The volume of liver calculated using the proposed approach is found comparable with that obtained using Myrian-XP, a currently followed surgery planning tool in clinical practice.

Conclusions: The obtained results from plain CT images will undoubtedly provide valuable diagnostic assistance and surgery planning even for the subset of patients for whom CECT acquisition is not advisable.