Evaluation of liver stiffness by 2D-SWE in combination with non-invasive parameters as predictors for esophageal varices in patients with advanced chronic liver disease

Petzold, Golo; Tsaknakis, Birgit; Bremer, Sebastian; Knoop, Richard F.; Goetze, Robert G.; Amanzada, Ahmad; Ellenrieder, Volker; Neeße, Albrecht; Kunsch, Steffen

doi:10.1080/00365521.2019.1585571

Cited by 16 publications

(12 citation statements)

References 27 publications

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“…Although the longitudinal and transverse diameters of the spleen and the splenic index increased with increasing stage of fibrosis, we failed to identify a satisfactory performance of the splenic index for the detection and staging of liver fibrosis in our patients. Petzold et al 30 revealed that the longitudinal diameter of the spleen had a better performance in detecting esophageal varices. Further studies are needed to confirm these findings.…”

Section: Discussionmentioning

confidence: 99%

“…Portal hypertension is a common complication in patients with advanced chronic liver disease. 30 Quite a few studies have been published on the noninvasive assessment of portal hypertension. [31][32][33][34][35][36] SS has been reported to be positively correlated with hepatic venous pressure gradient with a better performance in detecting portal hypertension better than LS.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of liver fibrosis with liver and spleen stiffness measured by sound touch elastography, serum fibrosis markers in patients with chronic hepatitis B

Dong

Huang

Lyu

et al. 2021

J of Digest Diseases

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To evaluate the performance of liver stiffness (LS) and spleen stiffness (SS) by using the sound touch elastography (STE) technique and compare with those of the splenic index, aspartate transaminase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4) index, King's score and combined models for diagnosing and staging fibrosis in chronic hepatitis B (CHB). Methods: One hundred patients with CHB underwent STE and serological tests. LS and SS values were measured with STE technique, and splenic index was calculated. Staging of fibrosis was determined with liver biopsy. Correlations between the individual parameters and the stage of fibrosis were evaluated with the Spearman correlation analysis. The area under the receiver operating characteristic curve (AUROC) was calculated to analyze the performance of all methods.Results: Among all individual parameters, LS showed the highest AUROC for diagnosing fibrosis of ≥S2, ≥S3, and S4 stages (AUROC: 0.70, 0.86, and 0.96, respectively; all P < 0.05). The AUROC of combined model 1 (LS and SS) and 2 (LS, SS, APRI, FIB-4 index, King's score) for diagnosing ≥S2, ≥S3, and S4 fibrosis were 0.70, 0.86, 0.97, and 0.70, 0.86, 0.96, respectively, which were higher than those of APRI, FIB-4 index and the King's score (P < 0.05). No significant differences were found between two combined models and LS for staging fibrosis (P > 0.05).Conclusions: LS measurement is reliable for diagnosing and staging fibrosis in CHB, with a better performance than SS, splenic index and serum biomarkers. It is also comparable with the performance of combined models.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of liver fibrosis with liver and spleen stiffness measured by sound touch elastography, serum fibrosis markers in patients with chronic hepatitis B

Dong

Huang

Lyu

et al. 2021

J of Digest Diseases

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“…[ 25 ] GBWT has been reported to correlate with the severity of portal hypertension and presence of GEV. [ 26 27 28 29 30 31 ] By using the practical nomogram, clinicians can quickly and reliably predict VNT. Besides, the nomogram maintained a superior performance of VNT, in comparison to other non-invasive predictors.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for predicting varices needing treatment in compensated advanced chronic liver disease

Wang

Wei

Duan

et al. 2021

Saudi Journal of Gastroenterology

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Background: Only a small proportion of patients with compensated advanced chronic liver disease (cACLD) had varices needing treatment (VNT) after recommended esophagogastroduodenoscopy (EGD) screening. We aimed to create a non-invasive nomogram based on routine tests to detect VNT in cACLD patients. Methods: The training cohort included 162 cACLD patients undergoing EGD in a university hospital, between January 2014 and September 2019. A nomogram was developed based on the independent predictors of VNT, selected using a multivariate logistic regression analysis. Thirty-three patients from eight university hospitals were prospectively enrolled as validation cohort between December 2018 and December 2019. Results: The prevalence of VNT was 32.7% (53/162) and 39.4% (13/33) in training and validation cohorts, respectively. The univariate analysis identified six risk factors for VNT. On the multivariate analysis, four of them, i.e., gallbladder wall thickness (odds ratio [OR]: 1.23; 95% confidence interval [CI]: 0.98-1.56), spleen diameter (OR: 1.02; 95% CI: 1.00-1.04), platelet count (OR: 0.98; 95% CI: 0.97-0.99), and international normalized ratio (OR: 0.58; 95% CI: 0.06-5.84) were independently associated with VNT. Thus, a nomogram based on the four above - mentioned variables was developed, and showed a favorable performance for detecting VNT, with an area under receiver operating characteristic curve of 0.848 (95% CI: 0.769-0.927) in training cohort. By applying a cut-off value of 105 in validation cohort, 31.0% of EGD were safely spared with 3.4% of missed VNT. Conclusion: A nomogram based on routine clinical parameters was developed for detecting VNT and avoiding unnecessary EGD in cACLD patients.

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“…And the endoscopists usually focus on the varices while underestimate the severity of PHG. However, there is absence of suitable non-invasive technique to assess PHG to date (8)(9)(10). Therefore, it is urgent to construct a non-invasive method to screen PHG in patients with cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

A Nomogram for Predicting Portal Hypertensive Gastropathy in Patients With Liver Cirrhosis: A Retrospective Analysis

Wang

Zhu

et al. 2022

Front. Med.

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BackgroundThere is an urgent need for non-invasive methods for predicting portal hypertensive gastropathy (PHG). This study aims to develop and validate a non-invasive method based on clinical parameters for predicting PHG in patients with liver cirrhosis (LC).MethodsThe overall survival (OS) and hepatocellular carcinoma (HCC)-free survival were evaluated in LC patients, both with and without PHG. A prediction model for PHG was then constructed based on a training dataset that contained data on 492 LC patients. The discrimination, calibration, and clinical utility of the predicting nomogram were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was conducted using a bootstrapping method, and further external validation using data on the 208 other patients.ResultsLC patients with PHG had a worse prognosis compared with those without PHG. A nomogram was constructed using clinical parameters, such as age, hemoglobin content, platelet count and Child-Pugh class. The C-index was 0.773 (95% CI: 0.730–0.816) in the training cohort, 0.761 after bootstrapping and 0.745 (95% CI: 0.673–0.817) in the validation cohort. The AUC values were 0.767, 0.724, and 0.756 in the training, validation and total cohorts, respectively. Well-fitted calibration curves were observed in the training and validation cohorts. Decision curve analysis demonstrated that the nomogram was clinically useful at a threshold of 15%.ConclusionThe nomogram constructed to predict the risk of developing PHG was found to be clinically viable. Furthermore, PHG is an independent risk factor for OS of LC, but not for the occurrence of HCC.

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Evaluation of liver stiffness by 2D-SWE in combination with non-invasive parameters as predictors for esophageal varices in patients with advanced chronic liver disease

Cited by 16 publications

References 27 publications

Assessment of liver fibrosis with liver and spleen stiffness measured by sound touch elastography, serum fibrosis markers in patients with chronic hepatitis B

Assessment of liver fibrosis with liver and spleen stiffness measured by sound touch elastography, serum fibrosis markers in patients with chronic hepatitis B

Development and validation of a nomogram for predicting varices needing treatment in compensated advanced chronic liver disease

A Nomogram for Predicting Portal Hypertensive Gastropathy in Patients With Liver Cirrhosis: A Retrospective Analysis

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