Assessing Baveno VI criteria with liver stiffness measured using a new point-shear wave elastography technique (BAVElastPQ study)

Matteo Garcovich, Enrico Di Stasio, Maria Assunta Zocco, Laura Riccardi, Maria Elena Ainora, Brigida Eleonora Annicchiarico, Giulia Gibiino, Francesco Santopaolo, Antonio Gasbarrini, Maurizio Pompili

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background and Aims: To date, no study has explored the potential role of ElastPQ, a novel point-SWE technique, in the assessment of clinically significant portal hypertension. The aim of our study was to determine a liver stiffness (LS) cut-off value measured by ElastPQ and laboratory parameters that could help to identify those patients who can safely avoid screening endoscopy. Methods: Data were collected on 1422 patients who underwent ElastPQ measurement from January 2013 to January 2016 in our Department. Inclusion criteria were a LS value of ≥7 kPa, an upper gastrointestinal endoscopy within 12 months and a diagnosis of compensated chronic liver disease. Exclusion criteria were history of decompensated liver disease, evidence of porto-spleno-mesenteric vein thrombosis and non-cirrhotic portal hypertension. Varices were graded as low-risk varices (grade <2) or varices needing treatment (VNT, grade ≥2). Results: The study included 195 patients (120 [61%] HCV, 171 [88%] Child-Pugh A). Varices were present in 35% cases, with 10% prevalence of VNT. According to ROC curve analysis, LS measurement and platelet count were evaluated as predictors of VNT. Overall, 75/195 (38%) met the ‘BAVElastPQ’ criteria (that is, LS < 12 kPa and platelet count >150 000/μL). Within this group, 11/75 (15%) had any grade of varices and only 1/75 (1%) had VNT. The BAVElastPQ criteria gave sensitivity of 0.95, specificity of 0.42, positive predictive value of 0.15 and negative predictive value of 0.99. Conclusions: The BAVElastPQ criteria correctly identified 99% of patients without VNT. By applying such criteria, we could have potentially avoided 38% of surveillance endoscopies in our cohort.
Lingua originaleEnglish
pagine (da-a)1952-1960
Numero di pagine9
RivistaLiver International
Volume40
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Elasticity Imaging Techniques
  • Esophageal and Gastric Varices
  • Humans
  • Hypertension, Portal
  • Liver
  • Liver Cirrhosis
  • liver fibrosis
  • liver stiffness
  • non-invasive assessment
  • portal hypertension
  • shear wave elastography

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