Total liver volume

Liver tissue is composed predominantly of cells called hepatocytes, which occupy 80-88% of the total liver volume in humans. Hepatocytes and other liver cells perform vital functions, such as... 

Activity depends on the body surface area (BSA) and the extent of tumor liver involvement. BSA in square meters was calculated using standard nomograms. Tumor liver involvement was measured on CT or MRI. The activity was then calculated using the formula Activity (GBq) = (BSA - 0,2) + (tumor volume/total liver volume). The calculated activity was reduced for patients with lung shunt from 10% to 20% and treatment was contraindicated if the lung shunt was higher than 20%. For those patients receiving lobar therapy, the activity could be reduced proportionally to the relative volume of the treated lobe compared to whole liver volume. 

Fig. 10.4a-c. Serious RE-induced liver toxicity was observed as a result of a significant proportion of the injected SIR-Spheres reaching the non tumoral liver, a The MAA scan obtained before RE shows significant activity in non-tumoral areas and tumors not clearly depicted. b,c CT or MRI scan of the liver before and 5 months after RE revealing a 28% decrease in total liver volume... 

Table 29.3. ANOVA results for ratio (transplanted tumors / total liver volume) estimates...

The dose calculation is based on the ratio of the tumor volume to the total liver volume, on the type of treatment (e.g., focal, lobar, whole liver), and whether resin or glass microspheres are used. To predict the distribution volume of the microspheres and to address the safety issues in terms of aberrant delivery, a pretreatment Tc MAA scan subsequent to the planning angiography is mandatory. 

Blood arriving at an organ of extraction normally contains only a fraction of the total drug present in the body. The flow through the major extraction organs, the liver and kidneys, is about 3 % of the total blood volume per minute, however, for many... 

Fluid load Lower concentrations of nitroglycerin IV and nitroglycerin in dextrose injection increase the potential precision of dosing, but these concentrations increase the total fluid volume that must be delivered to patients. Total fluid load may be a dominant consideration in patients with compromised function of the heart, liver, and/or kidneys. 

Smaller microcapsules [<350 pm] offer many advantages over standard microcapsules [700 to 1500 pm], including reduced total implant volume,better insulin kinetics [224],improved cell oxygenation [225], and potential access to diverse implantation sites, such as the spleen and liver. A new electrostatic pulse... 

Although the sinusoidal cells (31 million/mg liver) make up only a relatively small proportion of the liver volume (6.3%), they constitute 30-40% of the total cell number. The total surface area of their plasma membranes is 26.5% of the total membrane surface of all liver cells. (3, 5, 23, 27, 44, 52, 56, 59) (s. figS. 2.8, 2.9)... 

Because the liver is a soft, expansible structure, large volumes of blood can be stored in its vessels. The normal hepatic blood volume is 450 ml, or almost 10% of the normal human total blood volume. As much as an additional liter can be stored... 

The primary cell type of the liver is the hepatocyte. Hepatocytes, also known as the hepatic parenchymal cells, form the liver lobnles. Eighty percent of the liver volume is composed of hepatocytes, but only 60% of the total nnmber of cells in the liver... 

The total blood volume is unevenly distributed. About 84 percent of the entire blood volume is in the systemic circulation, with 64 percent in the veins, 13 percent in the arteries, and 7 percent in the arterioles and capillaries. The heart contains 7 percent of blood volume and the pulmonary vessels 9 percent. At normal resting activities heart rate of an adult is about 75 beats/min with a stroke volume of typically 70 mL/beat. The cardiac output, the amount of blood pumped each minute, is thus 5.25 L/min. It declines with age. During intense exercise, heart rate may increase to 150 beats/ min and stroke volume to 130 mL/beat, providing a cardiac output of about 20 L/min. Under normal conditions the distribution of blood flow to the various organs is brain, 14 percent heart, 4 percent kidneys, 22 percent liver, 27 percent inactive muscles, 15 percent bones, 5 percent skin, 6 percent ... 

The total dose to be delivered depends not on the tumor burden but on the total volume of the liver (normal parenchyma plus tumor) to be embolized. A CT or MRI should be obtained, based on which the liver volume to be embolized is calculated. The same MRI (which should include contrast-enhanced and diffusion/perfusion sequences) can be used as baseline to quantify the response to treatment. Studies have shown that a total dose of 120-150 Gy yields better results than lower doses [1,4,8]. The total activity to be injected is calculated by ... 

Indications for Portal Vein Embolization 164 Calculation of ERL/Total Functional Liver Volume Ratio 165... 

Along the last 10-year period we have performed PVE in 108 patients, before right hepatectomy in 43 cases, right extended hepatectomy in 58 cases and more complex hepatectomy in 7 cases (6.4%). We have reported a mean increase of 70% in the size of the ERL and a ratio of FRL/Total liver that increased by 12.4% and measured 32% four weeks after PVE [12]. Main series report increases in volume of 30 to 42 % and FRL/Total liver ratio increases from 19%-36% to 31%-59%. Disparities maybe explained... 

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