Variability of transient elastography-based spleen stiffness performed at 100 Hz

Area of Science:

• Hepatology and gastroenterology
• Medical imaging and diagnostics
• Non-invasive liver disease assessment

Background:

• Spleen stiffness measurement (SSM) via transient elastography at 100 Hz is emerging for portal hypertension evaluation in chronic liver disease.
• Technical standardization is needed for robust SSM clinical application.

Purpose of the Study:

• To evaluate the intraexamination variability of SSM at 100 Hz.
• To identify the optimal transient elastography protocol for reliable SSM in clinical practice.

Main Methods:

• Analysis of 253 SSM exams (up to 20 scans each) from April 2021 to June 2022.
• Comparison of different measurement protocols (n=2 to 19 scans) against a 20-scan median reference.
• 1,000 resampling analyses stratified by liver disease etiology and SSM ranges (<25 kPa, 25-75 kPa, >75 kPa).

Main Results:

• Spleen stiffness exams showed reduced variability with >12 measurements (absolute deviations ≤5 kPa at 95% confidence).
• For high SSM values (>75 kPa), associated with significant portal hypertension, ≥15 measurements are highly recommended.

Conclusions:

• A minimum of 15 scans per examination is recommended for 100 Hz SSM.
• This protocol ensures low intraexamination variability for clinical use, particularly in significant portal hypertension cases.