Adding 100 Hz Spleen Stiffness Measurement to the Baveno VII Model Improves Decompensation Risk Prediction in cACLD.

Area of Science:

• Hepatology
• Medical Imaging
• Diagnostic Tools

Background:

• Compensated advanced chronic liver disease (cACLD) carries a risk of hepatic decompensation.
• Spleen stiffness measurement (SSM) using a 100 Hz probe shows promise in diagnosing portal hypertension.
• The predictive value of 100 Hz-SSM, alone or with liver stiffness measurement (LSM), for decompensation in cACLD needs further evaluation.

Purpose of the Study:

• To assess the efficacy of 100 Hz-SSM in predicting hepatic decompensation in patients with cACLD.
• To determine if combining 100 Hz-SSM with LSM improves decompensation risk prediction.
• To evaluate the performance of novel risk models incorporating SSM and LSM.

Main Methods:

• Retrospective analysis of 371 cACLD patients (LSM ≥ 10 kPa) undergoing elastography.
• Collection of baseline elastography, laboratory, demographic, and clinical data.
• Recording of liver-related events over a median follow-up of 35 months to assess hepatic decompensation.

Main Results:

• Both LSM (C-index=0.79) and 100 Hz-SSM (C-index=0.70) predicted hepatic decompensation.
• The NICER model (Non-Invasive CSPH Estimated Risk), incorporating SSM, BMI, and platelets, showed improved prediction (C-index=0.84).
• The Baveno VII model combined with SSM stratified patients into distinct risk groups for decompensation (p<0.001).

Conclusions:

• LSM and 100 Hz-SSM are valuable for assessing decompensation risk in cACLD.
• Incorporating these measurements into risk models like NICER or Baveno VII enhances predictive accuracy.
• These non-invasive tools aid in managing patients with multi-etiological cACLD.