Assessing splenic enlargement on CT by unidimensional measurement changes in patients with colorectal liver metastases.

PURPOSE: The aim of this study was to assess splenic volume and to correlate unidimensional measurements with reference volumetric changes in chemotherapy-treated patients with colorectal cancer (CRC) liver metastases.

METHODS

Forty consecutive patients were selected from the cohort of a previously reported study of chemotherapy-related morbidity following major hepatectomy for CRC liver metastases. Patients were treated for 6 months prior to resection, with imaging performed at baseline and after 6 months of chemotherapy. Three unidimensional spleen measurements were recorded-width, thickness, and height (W, T, and H). Reference splenic volume was measured at baseline and after chemotherapy. The best unidimensional splenic measurement was determined by regression analysis. The 95% CI for the predicted values and R (2) values was calculated for each regression. The percentage of volume increase at 6 months was calculated.

RESULTS

W and H showed the highest correlation with splenic volume prior to and following chemotherapy (R (2) = 0.65-0.74, p < 0.001), while T showed a low correlation (R (2) = 0.11 and 0.18, p < 0.05). The mean reference splenic volume increased after 6 months of chemotherapy compared to baseline (326 vs. 278 mL). Splenic volume changes showed the highest correlation with changes in W (R (2) = 0.56, p < 0.001), then H (R (2) = 0.40, p < 0.001), but were not significantly correlated with changes in T (R (2) = 0.01, p = 0.055).

CONCLUSIONS

Our results show the potential utility of measuring changes in splenic width to predict clinically significant changes in splenic volume in chemotherapy-treated patients with CRC liver metastases.