430 Elastography for the Diagnosis of Severity of Fibrosis in Chronic Liver Disease. A Diagnostic Test Accuracy Meta-Analysis

Tsochatzis, Emmanuel; Gurusamy, Kurinchi Selvan; Ntaoula, S.; Davidson, Bennett; Burroughs, A.K.

doi:10.1016/s0168-8278(10)60432-1

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“…The LS cut-off value has to be redefined when SSI systems are used for including cACLD patients. According to the meta-analysis of Tsochatzis, the TE cut-off value for predicting F3 or higher liver fibrosis is 9.6 kPa, which is close to the LS value of 10 kPa proposed by the Baveno VI consensus workshop 11 . Sporea el al.…”

Section: Methodssupporting

confidence: 66%

Application of Supersonic Shear Imaging to the Baveno VI Criteria and a Combination Model with Spleen Stiffness Measurement to Rule Out High-Risk Varices in Compensated Advanced Chronic Liver Disease

2020

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Purpose Recently, Colecchia et al. reported that by adding a spleen stiffness (SS) criterion sequentially to the Baveno VI criteria, screening endoscopy could be safely avoided. We aimed to compare the Baveno VI criteria, SS values and a sequential combination of the Baveno VI and SS values, measured by supersonic shear imaging (SSI), as approaches for safely avoiding screening endoscopy for high-risk varices (HRV). Materials and Methods Between April 2017 and July 2018, we enrolled 274 compensated advanced chronic liver disease patients who had successfully undergone liver stiffness (LS) and SS measurements with SSI and esophagogastroduodenoscopy (EGD). 52 HRV patients were included, and we analyzed risk factors for HRV and compared proportions of patients who were spared EGD when Baveno VI criteria, SS cut-off and the combination of the two approaches were used. Results The AUROC values for estimating HRV by platelet count, LS and SS were 0.701, 0.757 and 0.844, respectively, and all three measures were found to be independent predictors of HRV. The SS cut-off value for excluding HRV was ≤ 27.3 kPa. The percentages of patients spared EGD were 18.6 % for Baveno VI, 28.8 % for SS cut-off and 36.1 % for the sequential combination of Baveno VI and SS cut-off. Less than 2 % of HRV patients were missed when using all of the criteria. Conclusion The Baveno VI criteria can be applied to LS measurement by SSI. SS measurement by SSI is an excellent predictor of HRV. Screening endoscopy can be safely avoided when Baveno VI criteria and SS cut-off are applied together.

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Section: Methodssupporting

confidence: 66%