Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography
Abstract Background and Aim Liver stiffness measurement (LSM) and spleen stiffness measurement (SSM@50 Hz) using standard vibration‐controlled transient elastography (VCTE) have been studied as a noninvasive test for screening of gastroesophageal varices (GEV) in chronic liver disease (CLD). Recentl...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12689 |
| _version_ | 1798025680333570048 |
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| author | Koki Nagai Yuji Ogawa Takashi Kobayashi Michihiro Iwaki Asako Nogami Yasushi Honda Takaomi Kessoku Yusuke Saigusa Kento Imajo Masato Yoneda Hiroyuki Kirikoshi Tatsuji Komatsu Satoru Saito Atsushi Nakajima |
| author_facet | Koki Nagai Yuji Ogawa Takashi Kobayashi Michihiro Iwaki Asako Nogami Yasushi Honda Takaomi Kessoku Yusuke Saigusa Kento Imajo Masato Yoneda Hiroyuki Kirikoshi Tatsuji Komatsu Satoru Saito Atsushi Nakajima |
| author_sort | Koki Nagai |
| collection | DOAJ |
| description | Abstract Background and Aim Liver stiffness measurement (LSM) and spleen stiffness measurement (SSM@50 Hz) using standard vibration‐controlled transient elastography (VCTE) have been studied as a noninvasive test for screening of gastroesophageal varices (GEV) in chronic liver disease (CLD). Recently, a novel spleen‐dedicated VCTE (SSM@100 Hz) has been developed. We evaluated the diagnostic performance of SSM@100 Hz, SSM@50 Hz, LSM, and other noninvasive tests using esophagogastroduodenoscopy (EGD) as the reference as well as the correlation with hepatic venous pressure gradient (HVPG). Methods A total of 123 patients with CLD enrolled in this cross‐sectional study. SSM@100 Hz, SSM@50 Hz, and LSM were determined by VCTE. EGD and HVPG were performed within 12 weeks before or after VCTE. Results GEV were present in 60 patients. Failure or suboptimal SSM were fewer at 100 Hz (4.0%) than at 50 Hz (17.7%). All SSM values obtained at 100 Hz were lower than the 100 kPa ceiling threshold, but 10 patients reached the 75 kPa ceiling threshold for SSM@50 Hz. SSM@100 Hz was most accurate (area under the receiver operating characteristic [AUROC] = 0.944) for the diagnosis of GEV compared to SSM@50 Hz, LSM, and scoring systems. AUROC of SSM@100 Hz for diagnosis of high‐bleeding risk varices (HRV) was 0.941, which was significantly higher than that of SSM@50 Hz (AUROC = 0.842, P = 0.002). SSM@100 Hz showed higher specificity (82.0%) for diagnosis of HRV than SSM@50 Hz (specificity = 67.1%). SSM@100 Hz was significantly correlated with HVPG (r = 0.71, P < 0.001). Conclusions The novel spleen‐dedicated VCTE examination can be used for noninvasive assessment of GEV and HVPG in CLD. Japan Registry of Clinical Trials Registry No. jRCTs032200119. |
| first_indexed | 2024-04-11T18:22:46Z |
| format | Article |
| id | doaj.art-0fcc40b7a7574d4e9799de4cac674442 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-04-11T18:22:46Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-0fcc40b7a7574d4e9799de4cac6744422022-12-22T04:09:43ZengWileyJGH Open2397-90702022-01-0161111910.1002/jgh3.12689Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastographyKoki Nagai0Yuji Ogawa1Takashi Kobayashi2Michihiro Iwaki3Asako Nogami4Yasushi Honda5Takaomi Kessoku6Yusuke Saigusa7Kento Imajo8Masato Yoneda9Hiroyuki Kirikoshi10Tatsuji Komatsu11Satoru Saito12Atsushi Nakajima13Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Biostatistics Yokohama City University School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Clinical Laboratory Yokohama City University Hospital Yokohama JapanDepartment of Gastroenterology National Hospital Organization Yokohama Medical Center Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Yokohama JapanAbstract Background and Aim Liver stiffness measurement (LSM) and spleen stiffness measurement (SSM@50 Hz) using standard vibration‐controlled transient elastography (VCTE) have been studied as a noninvasive test for screening of gastroesophageal varices (GEV) in chronic liver disease (CLD). Recently, a novel spleen‐dedicated VCTE (SSM@100 Hz) has been developed. We evaluated the diagnostic performance of SSM@100 Hz, SSM@50 Hz, LSM, and other noninvasive tests using esophagogastroduodenoscopy (EGD) as the reference as well as the correlation with hepatic venous pressure gradient (HVPG). Methods A total of 123 patients with CLD enrolled in this cross‐sectional study. SSM@100 Hz, SSM@50 Hz, and LSM were determined by VCTE. EGD and HVPG were performed within 12 weeks before or after VCTE. Results GEV were present in 60 patients. Failure or suboptimal SSM were fewer at 100 Hz (4.0%) than at 50 Hz (17.7%). All SSM values obtained at 100 Hz were lower than the 100 kPa ceiling threshold, but 10 patients reached the 75 kPa ceiling threshold for SSM@50 Hz. SSM@100 Hz was most accurate (area under the receiver operating characteristic [AUROC] = 0.944) for the diagnosis of GEV compared to SSM@50 Hz, LSM, and scoring systems. AUROC of SSM@100 Hz for diagnosis of high‐bleeding risk varices (HRV) was 0.941, which was significantly higher than that of SSM@50 Hz (AUROC = 0.842, P = 0.002). SSM@100 Hz showed higher specificity (82.0%) for diagnosis of HRV than SSM@50 Hz (specificity = 67.1%). SSM@100 Hz was significantly correlated with HVPG (r = 0.71, P < 0.001). Conclusions The novel spleen‐dedicated VCTE examination can be used for noninvasive assessment of GEV and HVPG in CLD. Japan Registry of Clinical Trials Registry No. jRCTs032200119.https://doi.org/10.1002/jgh3.12689gastroesophageal variceshepatic venous pressure gradientliver stiffness measurementportal hypertensionspleen stiffness measurement |
| spellingShingle | Koki Nagai Yuji Ogawa Takashi Kobayashi Michihiro Iwaki Asako Nogami Yasushi Honda Takaomi Kessoku Yusuke Saigusa Kento Imajo Masato Yoneda Hiroyuki Kirikoshi Tatsuji Komatsu Satoru Saito Atsushi Nakajima Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography JGH Open gastroesophageal varices hepatic venous pressure gradient liver stiffness measurement portal hypertension spleen stiffness measurement |
| title | Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography |
| title_full | Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography |
| title_fullStr | Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography |
| title_full_unstemmed | Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography |
| title_short | Gastroesophageal varices evaluation using spleen‐dedicated stiffness measurement by vibration‐controlled transient elastography |
| title_sort | gastroesophageal varices evaluation using spleen dedicated stiffness measurement by vibration controlled transient elastography |
| topic | gastroesophageal varices hepatic venous pressure gradient liver stiffness measurement portal hypertension spleen stiffness measurement |
| url | https://doi.org/10.1002/jgh3.12689 |
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