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CT-derived extracellular volume fraction (ECV), iodine washout rate (IWR), liver and spleen volumes normalized by body-surface-area (LV\/BSA and SpV\/BSA, respectively), and <jats:sup>99m<\/jats:sup>Tc-GSA-derived blood\u00a0clearance index (HH15) and liver\u00a0receptor index (LHL15) were quantified. Each parameter was compared between ICG-R15\u2009\u2265\u200920% (<jats:italic>n<\/jats:italic>\u2009=\u200922) and ICG-R15\u2009&lt;\u200920% (<jats:italic>n<\/jats:italic>\u2009=\u200996) groups. Correlations with ICG-R15 were analyzed. The diagnostic performance to predict ICG-R15\u2009\u2265\u200920% was assessed with areas under the receiver operating characteristic curve (AUC). Multivariable logistic regression analysis was used to identify independent CT predictors, and combined performance was determined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In the ICG-R15\u2009\u2265\u200920% group, IWR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), LV\/BSA (<jats:italic>p<\/jats:italic>\u2009=\u20090.026), LHL15 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were lower and ECV (<jats:italic>p<\/jats:italic>\u2009=\u20090.001), SpV\/BSA (<jats:italic>p<\/jats:italic>\u2009=\u20090.005), and HH15 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were higher compared to ICG-R15\u2009&lt;\u200920% group. ICG-R15 showed positive correlations with ECV (<jats:italic>r<\/jats:italic>\u2009=\u20090.355), SpV\/BSA (<jats:italic>r<\/jats:italic>\u2009=\u20090.248), and HH15 (<jats:italic>r<\/jats:italic>\u2009=\u20090.385), while negative correlations with IWR (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.523), LV\/BSA (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.123, not statistically significant), and LHL15 (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.504). The AUC of ECV, IWR, LV\/BSA, SpV\/BSA, HH15, and LHL15 were 0.719, 0.845, 0.653, 0.694, 0.844, and 0.878, respectively. IWR, SpV\/BSA, and LV\/BSA were independent predictors, with a combined AUC of 0.924.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>IWR predicted liver function better than ECV and hepatosplenic volumetry. The combined IWR and volumetry yielded an accurate prediction of severe liver dysfunction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Question<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Despite the widespread use of multiphase CT in patients with hepatobiliary diseases, its potential role in assessing liver function has been scarcely evaluated<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Findings<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Iodine washout rate (IWR), liver volume indexed by body surface area, and spleen volume indexed by body surface area were independent predictors for severe liver dysfunction<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Clinical relevance<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Combined IWR and hepatosplenic volumetry on routine hepatic CT may help assess hepatic function for optimizing treatment strategies and predicting patient prognosis<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00330-025-11497-1","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T09:50:02Z","timestamp":1741859402000},"page":"5781-5791","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Liver function estimation using multiphase hepatic CT: diagnostic performance of iodine-uptake and volumetric parameters"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3280-7346","authenticated-orcid":false,"given":"Yasunori","family":"Nagayama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masamichi","family":"Hokamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narumi","family":"Taguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Yokota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Osaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Ogasawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Shiraishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuya","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Harai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Kidoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seitaro","family":"Oda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Nakaura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinori","family":"Hirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"11497_CR1","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1016\/j.jamcollsurg.2006.12.032","volume":"204","author":"JT Mullen","year":"2007","unstructured":"Mullen JT, Ribero D, Reddy SK et al (2007) Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. 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