Korelasi Tumor to Liver Volume Ratio pada CT Scan Abdomen dengan Skor MELD pada Pasien Karsinoma Hepatoseluler

Raden Roro Pradina Paramita, Dr. dr. Bambang Supriyadi, Sp. Rad., Subsp. MSK (K), MM, dr. Bambang P.Utomo., Sp. Rad., Subsp.Abd(K), M.Med.Ed

2026 | Tesis-Spesialis | S2 Radiologi

Latar Belakang: Karsinoma hepatoseluler (KHS) merupakan kanker hati primer

tersering dengan angka mortalitas yang tinggi, terutama di Asia. Penilaian beban

tumor berperan dalam menentukan prognosis, namun pengukuran berbasis

diameter memiliki keterbatasan. Parameter volumetri seperti TTLVR dinilai lebih

mampu merepresentasikan beban tumor. Prognosis KHS juga dipengaruhi oleh

fungsi hati yang dapat dinilai secara objektif menggunakan MELD. Namun,

hubungan antara TTLVR dan skor MELD masih belum banyak diteliti.

Tujuan: Mengetahui korelasi TTLVR pada CT scan abdomen dengan skor MELD

pada pasien karsinoma hepatoseluler.

Metode: Penelitian ini merupakan studi potong lintang observasional yang

dilakukan di Departemen Radiologi dan Instalasi Catatan Medik RSUP Dr.

Sardjito, Yogyakarta. Subjek penelitian adalah pasien karsinoma hepatoseluler

yang menjalani pemeriksaan CT scan abdomen kontras multifase periode dari

Oktober 2024-September 2025. TTLVR dihitung dari citra CT scan menggunakan

metode segmentasi volumetrik semi automatis, sedangkan skor MELD dari data

laboratorium. Analisis korelasi antara TTLVR dan skor MELD dilakukan

menggunakan uji Spearman.

Hasil : Penelitian terhadap 53 pasien karsinoma hepatoseluler menunjukkan

terdapat hubungan bermakna antara TTLVR dan skor MELD dengan kekuatan

korelasi sedang (r = 0,406; p = 0,003). Analisis multivariat menunjukkan TTLVR

merupakan faktor independen yang berhubungan dengan skor MELD (B = 0,063;

p = 0,017), sedangkan variabel lain tidak menunjukkan hubungan bermakna.

Kesimpulan: TTLVR memiliki korelasi bermakna dan independen terhadap skor

MELD, sehingga dapat digunakan sebagai parameter kuantitatif tambahan dalam

menilai fungsi hati pada pasien karsinoma hepatoseluler.

Kata kunci: karsinoma hepatoseluler, tumor to total liver volume ratio, Model for

End Stage Liver Disease score, CT scan abdomen kontras multifase

Background: Hepatocellular carcinoma (HCC) is the most common primary liver

malignancy and is associated with high mortality, particularly in Asia. Tumor

burden assessment plays an important role in determining prognosis; however,

diameter-based measurements have limitations. Volumetric parameters such as the

tumor to total liver volume ratio (TTLVR) are considered to better represent tumor

burden. Prognosis in HCC is also influenced by liver function, which can be

objectively assessed using the Model for End-Stage Liver Disease (MELD) score.

However, the relationship between TTLVR and MELD score has not been widely

studied.

Objective: To evaluate the correlation between TTLVR measured on contrastenhanced

abdominal CT scans and the MELD score in patients with hepatocellular

carcinoma.

Methods: This was an observational cross-sectional study conducted at the

Department of Radiology and the Medical Records Unit of Dr. Sardjito General

Hospital, Yogyakarta. The study included patients with hepatocellular carcinoma

who underwent multiphasic contrast enhanced abdominal CT scans between

October 2024 and September 2025. TTLVR was calculated using semi-automated

volumetric segmentation from CT images, while MELD scores were obtained from

laboratory data. Correlation analysis between TTLVR and MELD score was

performed using Spearman’s test.

Results: A total of 53 patients with hepatocellular carcinoma were included. A

significant positive correlation was found between TTLVR and MELD score with

moderate strength (r = 0,406; p = 0,003). Multivariate analysis demonstrated that

TTLVR was an independent factor associated with MELD score (B = 0,063 ; p =

0,017), while other variables were not significantly associated.

Conclusion: TTLVR is significantly and independently associated with the MELD

score and may serve as an additional quantitative parameter in assessing liver

function in patients with hepatocellular carcinoma.

Keywords: hepatocellular carcinoma, tumor-to-total liver volume ratio, Model for

End Stage Liver Disease, multiphasic contrast enhanced abdominal CT

Kata Kunci : karsinoma hepatoseluler, tumor to total liver volume ratio, Model for End Stage Liver Disease score, CT scan abdomen kontras multifase