Non-invasive predictive model for hepatic venous pressure gradient based on a 3-dimensional computed tomography...

Area of Science:

• Medical Imaging
• Hepatology
• Radiology

Background:

• Portal hypertension in liver cirrhosis leads to severe complications like gastroesophageal variceal rupture, a major cause of mortality.
• Hepatic venous pressure gradient (HVPG) accurately quantifies portal hypertension severity but requires invasive measurement.
• There is a need for non-invasive methods to assess HVPG and guide clinical management of liver cirrhosis.

Purpose of the Study:

• To develop and validate a non-invasive method using 3D computed tomography (CT) volume rendering to predict HVPG in patients with liver cirrhosis.
• To establish a predictive model for HVPG based on readily available clinical and radiological data.
• To assess the accuracy of the developed model in identifying clinically significant portal hypertension.

Main Methods:

• Retrospective review of clinical and radiological data from 77 liver cirrhosis patients who underwent HVPG measurement.
• Construction of 3D liver and spleen models using CT volume rendering for volumetric analysis.
• Application of univariate and multivariate linear regression analyses to develop a predictive model for HVPG.

Main Results:

• A predictive model was established: HVPG = 18.726 - 0.324 (albumin) + 1.57 (aminotransferase-to-platelet ratio index) + 0.004 (liver volume) (P=0.006).
• The model demonstrated an area under the receiver operating characteristic curve of 0.810 for identifying HVPG ≥10 mmHg.
• An optimal cut-off value of 12.84 yielded 80.36% sensitivity and 76.19% specificity for clinically significant portal hypertension.

Conclusions:

• 3D CT volume rendering technology, combined with clinical parameters, can non-invasively predict HVPG in liver cirrhosis patients.
• This non-invasive approach shows potential for accurate assessment of portal hypertension severity, potentially avoiding invasive procedures.
• Further validation is warranted, but this method may improve the management of patients with liver cirrhosis and portal hypertension.