Evaluating the relationship between liver and spleen volumes in patients with liver cirrhosis using the Cavalieri principle on cross-sectional images

In the early stages of liver cirrhosis, hepatomegaly is observed, while in the later stages, enlargement of the spleen is observed due to shrinkage of the liver and increased pressure in the portal circulation. This study aims to investigate liver and spleen volumes in healthy individuals and patients with liver cirrhosis using Computed Tomography (CT) images and to examine the proportional relationship between these volumes. Present thesis study aims to determine changes in liver and spleen volumes across different stages of cirrhosis and analyze these parameters concerning sex differences. The study utilized CT images from 52 patient with liver cirrhosis (26 females, 26 males) and 52 healthy individual (26 females, 26 males) aged between 18 and 85. Using ImageJ software, liver and spleen volumes and the ratio of spleen volume to liver+spleen volume (spleen volume ratio) were calculated using the Cavalieri principle. The relationship between liver and spleen volumes and their proportional ratio was examined comparatively by sex in healthy and cirrhotic individuals. Additionally, volume and ratio changes were evaluated according to the stages of the disease in patients. Correlation analyses were performed between groups and by sex. In patients with liver cirrhosis, the liver volume (1488.9±502.3 cm3) was significantly larger than that of healthy individuals (1321.8±277.1 cm3) (p=0.038). Similarly, spleen volume in cirrhotic patients (676.8±347.02 cm3) was significantly larger than that of healthy individuals (249.37±101.16 cm3) (p<0.001). The spleen volume ratio was higher in cirrhotic patients (30.75%±12.22) compared to healthy individuals (15.68%±5.09) (p<0.001). There was no significant difference in volume ratios between genders in cirrhotic patients or healthy individuals (p>0.05). Liver volumes in cirrhotic patients at stages A, B, and C were 1670.7 cm3, 1357.4 cm3, and 1087.3 cm3, respectively, with corresponding spleen volume ratios of 26.71%, 33.49%, and 40.26%. As the cirrhosis stage progressed, liver volume decreased (p=0.010) and spleen volume ratio increased (p=0.020). A strong and positive correlation was observed between spleen volume and spleen volume ratio (r=0.836; p<0.001). This study demonstrates that liver and spleen volumes and the spleen volume ratio vary according to the stages of liver cirrhosis, and this ratio can be used as an indicator of disease progression. Liver and spleen volumes and their ratios can be used as normal value parameters independent of sex. Keywords: Liver, Spleen, Cirrhosis, Volume, Cavalieri principle