TY - JOUR
T1 - Assessing Baveno VI criteria with liver stiffness measured using a new point-shear wave elastography technique (BAVElastPQ study)
AU - Garcovich, Matteo
AU - Di Stasio, Enrico
AU - Zocco, Maria Assunta
AU - Riccardi, Laura
AU - Ainora, Maria Elena
AU - Annicchiarico, Brigida Eleonora
AU - Gibiino, Giulia
AU - Santopaolo, Francesco
AU - Gasbarrini, Antonio
AU - Pompili, Maurizio
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Elasticity Imaging Techniques
KW - Esophageal and Gastric Varices
KW - Humans
KW - Hypertension, Portal
KW - Liver
KW - Liver Cirrhosis
KW - liver fibrosis
KW - liver stiffness
KW - non-invasive assessment
KW - portal hypertension
KW - shear wave elastography
KW - Elasticity Imaging Techniques
KW - Esophageal and Gastric Varices
KW - Humans
KW - Hypertension, Portal
KW - Liver
KW - Liver Cirrhosis
KW - liver fibrosis
KW - liver stiffness
KW - non-invasive assessment
KW - portal hypertension
KW - shear wave elastography
UR - http://hdl.handle.net/10807/205027
U2 - 10.1111/liv.14558
DO - 10.1111/liv.14558
M3 - Article
SN - 1478-3223
VL - 40
SP - 1952
EP - 1960
JO - Liver International
JF - Liver International
ER -