Spleen Stiffness Determined by Spleen-dedicated Device Accurately Predicted Esophageal Varices in Cirrhosis Patients

Overview

Journal Ther Adv Chronic Dis

Publisher Sage Publications

Date 2023 Nov 6

PMID 37928628

Authors

Jiqing Liu

Hangfei Xu

Weiyuan Liu

Hongmei Zu

Huiguo Ding

Fankun Meng

Jing Zhang

Affiliations

Soon will be listed here.

Abstract

Background: The advantages of spleen stiffness in prediction of high-risk varices (HRV) in cirrhosis patients have been confirmed. Recently, a new device utilizing a 100 Hz probe dedicated to spleen stiffness measurement (SSM) was developed.

Objectives: To validate the clinical applicability of SSM@100 Hz in predicting HRV by comparing it with other non-invasive tests (NITs).

Design: A prospective cohort study.

Methods: A total of 171 cirrhosis patients who underwent esophagogastroduodenoscopy (EGD) examination were included in this study. SSM using a 100 Hz probe and liver stiffness measurement using a 50 Hz probe were performed. Additionally, 22 healthy controls underwent spleen stiffness evaluation using the 100 Hz probe.

Results: The failure rates of spleen stiffness examination in patients with cirrhosis and in healthy controls were 2.9% and 4.5%, respectively. The means of SSM values were 56.4 ± 21.6 and 13.8 ± 6.7 kPa in cirrhosis and controls. SSM increased proportionally with the severity of esophageal varices. The area under receiver operating characteristic (ROC) for spleen stiffness in predicting HRV was 0.881 (95% confidence interval 0.829-0.934), with a cutoff value of 43.4 kPa. The accuracy, false negative rate and EGD spare rate were 86.5%, 2.5% and 24.3%, respectively. For HRV prediction, SSM was comparable to expanded Baveno VI and VII and superior to other NITs. As to viral non-viral cirrhosis and compensated decompensated cirrhosis, the cut-off and performance of SSM were different.

Conclusion: SSM@100 Hz demonstrates high accuracy in predicting HRV with a low missed HRV rate. Our findings suggest that SSM@100 Hz can be used independently due to its simplicity and effectiveness. However, further studies are needed to determine appropriate cutoff values based on the cause of cirrhosis and liver function.

Trail Registration: ChiCTR2300070270.

Citing Articles

Improved Applicability and Diagnostic Accuracy of the Novel Spleen-Dedicated Transient Elastography Device for High-Risk Esophageal Varices.

Madir A, Barisic Jaman M, Milosevic M, Dinjar Kujundzic P, Grgurevic I Diagnostics (Basel). 2024; 14(7).

PMID: 38611656 PMC: 11011917. DOI: 10.3390/diagnostics14070743.

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