Improved Applicability and Diagnostic Accuracy of the Novel Spleen-Dedicated Transient Elastography Device for High-Risk Esophageal Varices

Spleen stiffness measurement (SSM) by transient elastography (TE) has been repeatedly demonstrated as the reliable way to rule out the presence of high-risk esophageal varices (HRV). We aimed to evaluate and compare novel vs. standard TE-SSM module performance in diagnosing HRV in patients with comp...

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Bibliographic Details
Published in:Diagnostics (Basel) 2024-04, Vol.14 (7), p.743
Main Authors: Madir, Anita, Barisic Jaman, Mislav, Milosevic, Marko, Dinjar Kujundžić, Petra, Grgurevic, Ivica
Format: Article
Language:English
Subjects:
Accuracy
Baveno VII criteria
Biopsy
Endoscopy
Esophageal varices
Esophagus
high-risk esophageal varices
Hypertension
Liver
Liver cirrhosis
Liver diseases
Medical research
Medicine, Experimental
Spleen
spleen stiffness measurement
transient elastography
Type 2 diabetes
Ultrasonic imaging
Varicose veins
Veins & arteries
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Summary:Spleen stiffness measurement (SSM) by transient elastography (TE) has been repeatedly demonstrated as the reliable way to rule out the presence of high-risk esophageal varices (HRV). We aimed to evaluate and compare novel vs. standard TE-SSM module performance in diagnosing HRV in patients with compensated advanced chronic liver disease (cACLD). This retrospective study included patients with cACLD; blood data, upper digestive endoscopy performed within 3 months of TE, SSM@50Hz and SSM@100Hz were collected. Overall, 112 patients with cACLD were analyzed (75.9% males, average age of 66, 43.7% alcohol-related chronic liver disease, 22.3% metabolic-associated steatotic liver disease, 6.2% viral hepatitis). Reliable SSM was possible in 80.3% and 93.8% of patients by using SSM@50Hz and SSM@100Hz probe, respectively. At the cut-off 41.8 kPa and 40.9 kPa (Youden), SSM@50Hz and SSM@100Hz had AUROCs of 0.746 and 0.752, respectively, for diagnosing HRV ( = 0.71). At the respective cut-offs, sensitivities for HRV were 92.9% and 100%, resulting in misclassification rates of 7.1% and 0% by using SSM@50Hz and SSM@100Hz. SSM reliably excludes HRV in cACLD patients, with measurements below 41 kPa potentially avoiding EGD in around 50% of cases, with minimal risk of HRV omission. SSM@100Hz demonstrated less measurement failures and no HRV misclassification.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics14070743