6533b81ffe1ef96bd127883b

RESEARCH PRODUCT

A New Sampling Method for Spleen Stiffness Measurement Based on Quantitative Acoustic Radiation Force Impulse Elastography for Noninvasive Assessment of Esophageal Varices in Newly Diagnosed HCV-Related Cirrhosis

Leonardo RizzoGiuseppe NunnariMassimo AttanasioLuca L'abbateMarilia Rita PinzoneAldo MorraBruno CacopardoLuca BalestreriMassimiliano BerrettaMichele Malaguarnera

subject

Liver CirrhosisMaleGenetics and Molecular Biology (all)CirrhosisData InterpretationImmunology and Microbiology (all)lcsh:MedicineVarices assessementLikelihood ratios in diagnostic testingGastroenterologyBiochemistryEsophageal varicesComputer-AssistedUltrasonographymedicine.diagnostic_testAUROCMedicine (all)General MedicineHepatitis CStatisticalMiddle AgedHepatitis CCirrhosisData Interpretation StatisticalFemaleElastographyViral hepatitisAlgorithmsAged; Algorithms; Data Interpretation Statistical; Elastic Modulus; Esophageal and Gastric Varices; Female; Hepatitis C; Humans; Image Interpretation Computer-Assisted; Liver Cirrhosis; Male; Middle Aged; Reproducibility of Results; Sample Size; Sensitivity and Specificity; Spleen; Stress Mechanical; Biochemistry Genetics and Molecular Biology (all); Immunology and Microbiology (all); Medicine (all)medicine.medical_specialtyArticle SubjectEsophageal and Gastric VaricesStressSensitivity and SpecificityGeneral Biochemistry Genetics and Molecular BiologyInternal medicineElastic ModulusImage Interpretation Computer-AssistedmedicineHumansAcoustic radiation forceImage InterpretationAgedGeneral Immunology and Microbiologybusiness.industrylcsh:RReproducibility of Resultsmedicine.diseaseMechanicalEndoscopySample SizeClinical StudyStress MechanicalbusinessSpleen

description

In our study, we evaluated the feasibility of a new sampling method for splenic stiffness (SS) measurement by Quantitative Acoustic Radiation Force Impulse Elastography (Virtual Touch Tissue Quantification (VTTQ)).We measured SS in 54 patients with HCV-related cirrhosis of whom 28 with esophageal varices (EV), 27 with Chronic Hepatitis C (CHC) F1–F3, and 63 healthy controls. VTTQ-SS was significantly higher among cirrhotic patients with EV (3.37 m/s) in comparison with controls (2.19 m/s,P<0.001), CHC patients (2.37 m/s,P<0.001), and cirrhotic patients without EV (2.7 m/s,P<0.001). Moreover, VTTQ-SS was significantly higher among cirrhotic patients without EV in comparison with both controls (P<0.001) and CHC patients (P<0.01). The optimal VTTQ-SS cut-off value for predicting EV was 3.1 m/s (AUROC = 0.96, sensitivity 96.4%, specificity 88.5%, positive predictive value 90%, negative predictive value 96%, positive likelihood ratio 8.36, and negative likelihood ratio 0.04). In conclusion, VTTQ-SS is a promising noninvasive and reliable diagnostic tool to screen cirrhotic patients for EV and reduce the need for upper gastrointestinal endoscopy. By using our cut-off value of 3.1 m/s, we would avoid endoscopy in around 45% of cirrhotic subjects, with significant time and cost savings.

yearjournalcountryeditionlanguage
2014-03-01
10.1155/2014/365982http://hdl.handle.net/10447/96347