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Spleen Stiffness for Predicting Varices Needing Treatment: Comparison between Two Different Elastography Techniques
Renata Fofiu1, Felix Bende1, Raluca Lupuşoru1
1Department of Gastroenterology and Hepatology, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania.
Spleen stiffness measurements using point shear wave elastography (pSWE) and 2D-shear wave elastography (2D-SWE) reliably predict esophageal varices needing treatment in liver cirrhosis patients, with comparable accuracy between the two methods.
Area of Science:
- Hepatology and Gastroenterology
- Medical Imaging and Diagnostics
- Noninvasive Biomarker Research
Background:
- Esophageal varices are a serious complication of liver cirrhosis, necessitating accurate prediction for timely treatment.
- Current diagnostic methods like endoscopy are invasive; noninvasive markers are sought to improve patient management.
- Spleen stiffness has emerged as a potential noninvasive indicator of portal hypertension severity in cirrhosis.
Purpose of the Study:
- To evaluate spleen stiffness measurements obtained via two elastography techniques as noninvasive predictors of esophageal varices requiring treatment.
- To compare the diagnostic performance of point shear wave elastography (pSWE) and 2D-shear wave elastography (2D-SWE) in this context.
- To establish optimal spleen stiffness cut-off values for predicting significant varices.
Main Methods:
- A prospective study included 107 patients with compensated liver cirrhosis.
- Spleen stiffness was measured using pSWE (Virtual Touch Quantification) and 2D-SWE (LOGIQ E9).
- Upper digestive endoscopy was performed to confirm the presence and severity of varices; 98 patients were analyzed.
Main Results:
- High feasibility rates were achieved for both techniques (2D-SWE: 96.2%, pSWE: 94.4%).
- Optimal spleen stiffness cut-off values were identified: 13.2 kPa for 2D-SWE (AUROC 0.84) and 2.91 m/s for pSWE (AUROC 0.90).
- No statistically significant difference was found in the performance of pSWE and 2D-SWE for predicting varices needing treatment (p=0.1606).
Conclusions:
- Spleen stiffness, measured by either 2D-SWE or pSWE, serves as a reliable noninvasive marker for predicting esophageal varices needing treatment in liver cirrhosis.
- Both elastography techniques demonstrate good feasibility, applicability, and predictive accuracy.
- The study concludes that there is no significant difference in performance between pSWE and 2D-SWE for this clinical application.
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