Assessment Of Spleen Size Research Articles

Sickle cell disease: Reducing the global disease burden.

Sickle cell disease has been largely an invisible global health issue, especially in regions of high incidence mainly due to lack of awareness among both the local health policy makers and the public. Public health interventions, such as screening of newborns, provision of prophylaxis against bacterial infections, and immunizations against pneumococcal infections can have the greatest impact. Family education on assessment of spleen size and subsequent detection of splenic sequestration and promptness to seek medical attention for a febrile child is also important in the control of the morbidity and mortality of children with SCD living in resource-poor countries. In addition to these affordable interventions, hydroxyurea therapy is necessary to decrease both the acute and chronic complications of sickle cell anemia. Sickle cell disease has been recognized to have global health significance by key institutions including the World Health Organization in 2006 and the United Nation is 2008. In 2010, the WHO released national health care management goals and set targets to be achieved by the countries in sub-Saharan Africa for the control and management of SCD. These are yet to be translated into action. To do, this would require active and sustainable public-private partnerships for sustainable program development in these regions. Effective interventions should be integrated into existing health systems, the best examples linking primary healthcare facilities to specialized sickle cell disease centers in regional and tertiary healthcare institutions.

Comparison of Spleen Volumes Estimated Using Planimetry and Prolate Ellipsoid Methods on MRI in Myelofibrosis Patients

Background: Splenomegaly is one of the most characteristic features of myelofibrosis (MF) with significant impact on the quality of life of patients. About 10% of MF patients present with severely symptomatic splenomegaly at diagnosis; another 50% develop it within 4 years of diagnosis. Pharmaceutical drug trials aimed at treating myelofibrosis have assessment of spleen size as one of its key trial endpoints. While assessment of spleen size (volume) by palpation is routinely performed in the clinic, unfortunately, it is not a precise and reliable method, a key requirement in drug trials. Medical imaging methods such as magnetic resonance imaging (MRI) and computed tomography (CT) provide a non-invasive approach to assessment of spleen volume. Both modalities allow acquisition of cross sectional abdominal images and enable full anatomical coverage of the spleen. Due to radiation concerns, MRI is preferred over CT modality. There are two approaches for analyzing cross sectional images for estimation of spleen volume - the planimetry method, that involves delineating spleen contours on each spleen slice to estimate complete spleen volume and the prolate ellipsoid method, that approximates the spleen to an ellipsoid structure and estimates spleen volume by using the prolate ellipsoid method (described below). The prolate method is a simple and quick way to assess spleen size compared to the planimetry method. However, the former method provides an approximate estimate of spleen size. The goal of this study was to compare the prolate method with planimetry method for estimating spleen volume for use in pharmaceutical clinical trials.Methods: A retrospective assessment of spleen volume in N=30 subjects with confirmed diagnosis of myelofibrosis was performed. All measurements were performed on T2 weighted MR images (5mm slice thickness/0.0 gap), acquired on MRI scanners from different manufacturers. All images were assessed for image quality prior to including them in the analysis and images without any images quality issues were included in this study. The analysis methods and calculation used for estimating spleen volume were as below:•Planimetry: Volume = ∑ [(Region of interest outlining the spleen boundary per slice) x (Slice thickness)].•Prolate Ellipsoid: Volume = 0.52 x (Longest diameter of the spleen) x (longest perpendicular diameter on the same trans-axial slice) x (vertical distance between the most superior and most inferior margins of the spleen)Results: Spleen volume estimated by planimetry and prolate method was 2113cc±1612cc and 2186cc±1538cc (mean ± Standard Deviation [S.D.]). The range of planimetry spleen volumes in this study was 210 to 5750cc. A plot of spleen volumes estimated using planimetry and prolate method showed high correlation (R2 = 0.97) between the two methods, however, the volume variation tends to increase for large spleen sizes. The Bland-Altman plot for comparing the two methods showed mean difference in measures (73 cc) and difference variation (1 S.D. =300cc).Conclusions: Prolate method is a simple and useful alternate method for assessing spleen volume that does not require any specialized software for delineating spleen boundaries. However, the implementation of prolate method is operator dependent and requires precise positioning of digital calipers on images. Future work involves comparing the two methods with respect to change in spleen volume compared to baseline, an assessment performed routinely in pharmaceutical clinical trials. DisclosuresNo relevant conflicts of interest to declare.

Assessment of Rabbit Spleen Size Using Ultrasonography

Assessment of spleen size using the ultrasonography has become a standard practice in human. However, the assessment is not established method in experimental animals. To establish the index to assess the spleen size using ultrasonography, we measured the cross-section image of rabbit spleen during endotoxin shock. The image of the cross-section was appeared as triangle, and the height of the triangular image was defined as the spleen index. This spleen index showed strong correlation with the spleen weight. In conclusion, this method is suitable for observation of changes in rabbit spleen size and may reduce the number of rabbit in the longitudinal studies.