{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:09:34Z","timestamp":1792782574565,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig","id":[{"id":"https:\/\/ror.org\/028hv5492","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Abdom Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To identify imaging and clinical factors associated with future liver remnant (FLR) hypertrophy after portal vein embolization (PVE) prior to major hepatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective single-center study included 98 patients (mean age 61\u2009\u00b1\u200914\u00a0years, 56 female) with benign or malignant liver tumors who underwent PVE between 2019 and 2024 before planned major liver resection. 10 patients also received liver venous deprivation (LVD). FLR volumes were measured on cross-sectional imaging before and after PVE. Embolic agent, cholestasis, arterial perfusion patterns, signal intensities in MRI, spleen volume, and venous diameters were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean FLR growth was 35.6\u2009\u00b1\u200922.2% (628.9\u2009\u00b1\u2009256.2 to 979.6\u2009\u00b1\u2009313.8\u00a0ml (p\u2009&lt;\u20090.001)). Patients undergoing combined LVD demonstrated significantly greater FLR hypertrophy (mean FLR growth 61.3\u2009\u00b1\u200923.1%, 422\u2009\u00b1\u200997\u00a0ml; p\u2009&lt;\u20090.001) compared with PVE alone. Arterial hyperperfusion of the embolized liver lobe was found to be associated with increased FLR growth (p\u2009=\u20090.036). Isolated cholestasis confined to the embolized lobe was also associated with greater FLR hypertrophy (p\u2009=\u20090.038), whereas cholestasis involving the FLR was associated with impaired growth (p\u2009=\u20090.042). No significant difference in FLR hypertrophy was observed regarding the used embolic agent (p\u2009=\u20090.11). Splenic volume increased significantly following PVE (311.9\u2009\u00b1\u2009146.5\u00a0mL after PVE vs. 271.3\u2009\u00b1\u2009118.5\u00a0mL prior to PVE, p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Imaging features such as arterial hyperperfusion and cholestasis of the embolized liver lobe, and postinterventional splenic enlargement are associated with larger FLR-growth. These findings may provide valuable early indicators of regenerative response and could help refine patient selection for PVE and hepatectomy, warranting further prospective evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00261-026-05540-y","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T12:36:23Z","timestamp":1778589383000},"page":"5827-5837","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Imaging biomarkers of liver hypertrophy after portal vein embolization in patients with liver tumors: cholestasis, arterial hyperperfusion, and splenic response"],"prefix":"10.1007","volume":"51","author":[{"given":"Anne B.","family":"Beeskow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karoline","family":"Rucker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Leonhardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aboelyazid","family":"Elkilany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Seehofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Michael","family":"Tautenhahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"van B\u00f6mmel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"G\u00f6\u00dfmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timm","family":"Denecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Struck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"5540_CR1","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.4251\/wjgo.v14.i11.2088","volume":"14","author":"G Cassese","year":"2022","unstructured":"Cassese, G. et al. Portal vein embolization failure: Current strategies and future perspectives to improve liver hypertrophy before major oncological liver resection. World J. Gastrointest. Oncol. 14, 2088\u20132096 (2022).","journal-title":"World J. Gastrointest. Oncol."},{"key":"5540_CR2","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1002\/jso.27738","volume":"130","author":"I Sivakumar","year":"2024","unstructured":"Sivakumar, I. & Liddell, R. P. A review of portal vein embolization prior to hepatic resection. J. Surg. Oncol. 130, 435\u2013442 (2024).","journal-title":"J. Surg. Oncol."},{"key":"5540_CR3","doi-asserted-by":"publisher","first-page":"1770","DOI":"10.7150\/jca.50371","volume":"12","author":"Y Huang","year":"2021","unstructured":"Huang, Y. et al. Preoperative Portal Vein Embolization for Liver Resection: An updated meta-analysis. J. Cancer 12, 1770\u20131778 (2021).","journal-title":"J. Cancer"},{"key":"5540_CR4","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s00423-023-03213-8","volume":"409","author":"F Werey","year":"2023","unstructured":"Werey, F. et al. Right portal vein ligation is still relevant for left hemi-liver hypertrophy: results of a comparative study using a propensity score between right portal vein ligation and embolization. Langenbecks Arch. Surg. 409, 25 (2023).","journal-title":"Langenbecks Arch. Surg."},{"key":"5540_CR5","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.surg.2018.11.004","volume":"165","author":"F Rassam","year":"2019","unstructured":"Rassam, F. et al. Functional and volumetric assessment of liver segments after portal vein embolization: Differences in hypertrophy response. Surgery 165, 686\u2013695 (2019).","journal-title":"Surgery"},{"key":"5540_CR6","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1007\/s00270-013-0565-7","volume":"36","author":"B Guiu","year":"2013","unstructured":"Guiu, B. et al. Portal vein embolization before right hepatectomy: improved results using n-butyl-cyanoacrylate compared to microparticles plus coils. Cardiovasc. Intervent. Radiol. 36, 1306\u20131312 (2013).","journal-title":"Cardiovasc. Intervent. Radiol."},{"key":"5540_CR7","doi-asserted-by":"publisher","first-page":"5464","DOI":"10.1007\/s00330-020-07685-w","volume":"31","author":"A Ali","year":"2021","unstructured":"Ali, A., Ahle, M., Bj\u00f6rnsson, B. & Sandstr\u00f6m, P. Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis. Eur. Radiol. 31, 5464\u20135478 (2021).","journal-title":"Eur. Radiol."},{"key":"5540_CR8","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1007\/s00270-021-03014-w","volume":"45","author":"U Carling","year":"2022","unstructured":"9.Carling, U., R\u00f8sok, B., Berger, S., Fretland, \u00c5. A. & Dorenberg, E. Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? Cardiovasc. Intervent. Radiol. 45, 450\u2013458 (2022).","journal-title":"Cardiovasc. Intervent. Radiol."},{"key":"5540_CR9","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1007\/s00423-020-01960-6","volume":"406","author":"J Heil","year":"2021","unstructured":"10.Heil, J. & Schadde, E. Simultaneous portal and hepatic vein embolization before major liver resection. Langenbecks Arch. Surg. 406, 1295\u20131305 (2021).","journal-title":"Langenbecks Arch. Surg."},{"key":"5540_CR10","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.hbpd.2022.08.013","volume":"22","author":"P Gavriilidis","year":"2023","unstructured":"11.Gavriilidis, P., Marangoni, G., Ahmad, J. & Azoulay, D. Simultaneous portal and hepatic vein embolization is better than portal embolization or ALPPS for hypertrophy of future liver remnant before major hepatectomy: A systematic review and network meta-analysis. Hepatobiliary Pancreat. Dis. Int. HBPD INT 22, 221\u2013227 (2023).","journal-title":"Hepatobiliary Pancreat. Dis. Int. HBPD INT"},{"key":"5540_CR11","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1016\/j.hpb.2024.07.409","volume":"26","author":"L Yang","year":"2024","unstructured":"12.Yang, L. et al. Comparison of liver venous deprivation with portal vein embolization alone in patients undergoing major liver resection: a systematic review and meta-analysis. HPB 26, 1329\u20131338 (2024).","journal-title":"HPB"},{"key":"5540_CR12","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.jvir.2024.09.025","volume":"36","author":"S Gadani","year":"2025","unstructured":"13.Gadani, S. et al. Liver Vein Deprivation versus Portal Vein Embolization: Retrospective Review of Safety and Effectiveness. J. Vasc. Interv. Radiol. 36, 31-39.e2 (2025).","journal-title":"J. Vasc. Interv. Radiol."},{"key":"5540_CR13","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1007\/s00270-022-03107-0","volume":"45","author":"G B\u00f6ning","year":"2022","unstructured":"14.B\u00f6ning, G. et al. Liver Venous Deprivation (LVD) Versus Portal Vein Embolization (PVE) Alone Prior to Extended Hepatectomy: A Matched Pair Analysis. Cardiovasc. Intervent. Radiol. 45, 950\u2013957 (2022).","journal-title":"Cardiovasc. Intervent. Radiol."},{"key":"5540_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2025.109345","volume":"182","author":"AY Li","year":"2025","unstructured":"15.Li, A. Y. et al. Postoperative hepatic insufficiency despite preoperative portal vein embolization: Not just about the volumetrics. Surgery 182, 109345 (2025).","journal-title":"Surgery"},{"key":"5540_CR15","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.ejrad.2016.02.008","volume":"85","author":"BK Barth","year":"2016","unstructured":"16.Barth, B. K., Fischer, M. A., Kambakamba, P., Lesurtel, M. & Reiner, C. S. Liver-fat and liver-function indices derived from Gd-EOB-DTPA-enhanced liver MRI for prediction of future liver remnant growth after portal vein occlusion. Eur. J. Radiol. 85, 843\u2013849 (2016).","journal-title":"Eur. J. Radiol."},{"key":"5540_CR16","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.hpb.2019.08.002","volume":"22","author":"K Araki","year":"2020","unstructured":"17.Araki, K. et al. Functional remnant liver volumetry using Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) predicts post-hepatectomy liver failure in resection of more than one segment. HPB 22, 318\u2013327 (2020).","journal-title":"HPB"},{"key":"5540_CR17","doi-asserted-by":"publisher","first-page":"znaf103","DOI":"10.1093\/bjs\/znaf103","volume":"112","author":"WC Bartholom\u00e4","year":"2025","unstructured":"18.Bartholom\u00e4, W. C. et al. Magnetic resonance-derived hepatic uptake index improves the identification of patients at risk of severe post-hepatectomy liver failure. Br. J. Surg. 112, znaf103 (2025).","journal-title":"Br. J. Surg."},{"key":"5540_CR18","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1007\/s00270-021-02877-3","volume":"44","author":"EA Soykan","year":"2021","unstructured":"19.Soykan, E. A. et al. Predictive Factors for Hypertrophy of the Future Liver Remnant After Portal Vein Embolization: A Systematic Review. Cardiovasc. Intervent. Radiol. 44, 1355\u20131366 (2021).","journal-title":"Cardiovasc. Intervent. Radiol."},{"key":"5540_CR19","doi-asserted-by":"publisher","first-page":"687","DOI":"10.2214\/AJR.19.21440","volume":"214","author":"S Kohno","year":"2020","unstructured":"20.Kohno, S. et al. Portal Vein Embolization: Radiological Findings Predicting Future Liver Remnant Hypertrophy. AJR Am. J. Roentgenol. 214, 687\u2013693 (2020).","journal-title":"AJR Am. J. Roentgenol."},{"key":"5540_CR20","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.jvir.2018.10.014","volume":"30","author":"EA Takahashi","year":"2019","unstructured":"21.Takahashi, E. A., Fleming, C. J. & Andrews, J. C. Future Liver Remnant Hypertrophy after Portal Vein Embolization Is Inversely Correlated with Intrahepatic Tumor Burden. J. Vasc. Interv. Radiol. 30, 435\u2013439 (2019).","journal-title":"J. Vasc. Interv. Radiol."},{"key":"5540_CR21","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1053\/j.gastro.2019.01.042","volume":"156","author":"PJ Eddowes","year":"2019","unstructured":"23.Eddowes, P. J. et al. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 156, 1717\u20131730 (2019).","journal-title":"Gastroenterology"},{"key":"5540_CR22","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1002\/hep.1840070408","volume":"7","author":"C Infante-Rivard","year":"1987","unstructured":"24.Infante-Rivard, C., Esnaola, S. & Villeneuve, J.-P. Clinical and statistical validity of conventional prognostic factors in predicting short-term survival among cirrhotics. Hepatology 7, 660\u2013664 (1987).","journal-title":"Hepatology"},{"key":"5540_CR23","doi-asserted-by":"publisher","first-page":"1334661","DOI":"10.3389\/fmed.2023.1334661","volume":"10","author":"MA Chaouch","year":"2024","unstructured":"25.Chaouch, M. A. et al. A systematic review and meta-analysis of liver venous deprivation versus portal vein embolization before hepatectomy: future liver volume, postoperative outcomes, and oncological safety. Front. Med. 10, 1334661 (2024).","journal-title":"Front. Med."},{"key":"5540_CR24","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.3390\/cancers16111982","volume":"16","author":"B Al Taweel","year":"2024","unstructured":"26.Al Taweel, B. et al. Assessment of Segmentary Hypertrophy of Future Remnant Liver after Liver Venous Deprivation: A Single-Center Study. Cancers 16, 1982 (2024).","journal-title":"Cancers"},{"key":"5540_CR25","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s00423-023-02784-w","volume":"408","author":"X Chang","year":"2023","unstructured":"27.Chang, X. et al. Influence of cholestasis on portal vein embolization-induced hypertrophy of the future liver remnant. Langenbecks Arch. Surg. 408, 54 (2023).","journal-title":"Langenbecks Arch. Surg."},{"key":"5540_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2024.101101","volume":"6","author":"K Huang","year":"2024","unstructured":"28.Huang, K. et al. Bile acids attenuate hepatic inflammation during ischemia\/reperfusion injury. JHEP Rep. 6, 101101 (2024).","journal-title":"JHEP Rep."},{"key":"5540_CR27","unstructured":"The Role of the Spleen in Portal Hypertension - PubMed. https:\/\/pubmed.ncbi.nlm.nih.gov\/36908126\/."},{"key":"5540_CR28","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.surg.2018.03.014","volume":"164","author":"K Mohkam","year":"2018","unstructured":"30.Mohkam, K. et al. Hepatic venous pressure gradient after portal vein embolization: An accurate predictor of future liver remnant hypertrophy. Surgery 164, 227\u2013232 (2018).","journal-title":"Surgery"},{"key":"5540_CR29","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1093\/bjs\/znad233","volume":"110","author":"F Primavesi","year":"2023","unstructured":"31.Primavesi, F. et al. E-AHPBA\u2013ESSO\u2013ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy. Br. J. Surg. 110, 1331\u20131347 (2023).","journal-title":"Br. J. Surg."},{"key":"5540_CR30","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.surg.2020.03.005","volume":"168","author":"A Abdelrafee","year":"2020","unstructured":"32.Abdelrafee, A. et al. Predictors of unresectability after portal vein embolization for centrally located cholangiocarcinoma. Surgery 168, 287\u2013296 (2020).","journal-title":"Surgery"},{"key":"5540_CR31","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1097\/SLA.0b013e3182733f09","volume":"256","author":"LT Hoekstra","year":"2012","unstructured":"33.Hoekstra, L. T. et al. Tumor Progression After Preoperative Portal Vein Embolization. Ann. Surg. 256, 812\u2013818 (2012).","journal-title":"Ann. Surg."},{"key":"5540_CR32","doi-asserted-by":"publisher","first-page":"294","DOI":"10.3390\/cancers12020294","volume":"12","author":"E Birgin","year":"2020","unstructured":"34.Birgin, E. et al. Contralateral Liver Hypertrophy and Oncological Outcome Following Radioembolization with 90Y-Microspheres: A Systematic Review. Cancers 12, 294 (2020).","journal-title":"Cancers"},{"key":"5540_CR33","doi-asserted-by":"publisher","first-page":"379","DOI":"10.21037\/hbsn.2017.02.03","volume":"6","author":"F Huisman","year":"2017","unstructured":"35.Huisman, F., Cieslak, K. P., van Lienden, K. P., Bennink, R. J. & van Gulik, T. M. Liver related complications in unresectable disease after portal vein embolization. Hepatobiliary Surg. Nutr. 6, 379\u2013386 (2017).","journal-title":"Hepatobiliary Surg. Nutr."},{"key":"5540_CR34","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1007\/s00270-024-03743-8","volume":"47","author":"T Bilhim","year":"2024","unstructured":"36.Bilhim, T., B\u00f6ning, G., Guiu, B., Luz, J. H. & Denys, A. CIRSE Standards of Practice on Portal Vein Embolization and Double Vein Embolization\/Liver Venous Deprivation. Cardiovasc. Intervent. Radiol. 47, 1025\u20131036 (2024).","journal-title":"Cardiovasc. Intervent. Radiol."}],"container-title":["Abdominal Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00261-026-05540-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00261-026-05540-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00261-026-05540-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:34:42Z","timestamp":1792085682000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00261-026-05540-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,11]]}},"alternative-id":["5540"],"URL":"https:\/\/doi.org\/10.1007\/s00261-026-05540-y","relation":{},"ISSN":["2366-0058"],"issn-type":[{"value":"2366-0058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"assertion":[{"value":"16 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Institutional ethics committee approval was obtained (Ethics Committee of the Medical Faculty of Leipzig University, reference 002\/25-ek).","order":2,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written and informed consent for data analysis and publication was obtained from all patients.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}