A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteria
Abstract Few studies have reported on acoustic radiation force impulse (ARFI) for varices screening. Our study aimed to identify a strategy based on liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) by ARFI combined with platelet count (PLT), named the ARP strategy, for ruling...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health/LWW
2022-11-01
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| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.2076 |
| _version_ | 1827882678346579968 |
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| author | Yifei Huang Lili Zhao Ruiling He Shuang Li Chuan Liu Xiaolong Qi Jia Li |
| author_facet | Yifei Huang Lili Zhao Ruiling He Shuang Li Chuan Liu Xiaolong Qi Jia Li |
| author_sort | Yifei Huang |
| collection | DOAJ |
| description | Abstract Few studies have reported on acoustic radiation force impulse (ARFI) for varices screening. Our study aimed to identify a strategy based on liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) by ARFI combined with platelet count (PLT), named the ARP strategy, for ruling out high‐risk varices (HRV) and avoiding unnecessary esophagogastroduodenoscopy (EGD) in patients with compensated cirrhosis. We retrospectively reviewed patients who underwent ARFI from a previous cohort (NCT04307264). Of them, patients between 2017 and 2019 composed the training cohort to develop the ARP strategy. The validation cohort consisted of others between 2015 and 2016 to validate and compare it with Baveno VI criteria about the performance for varices screening. Primary outcomes were the rates of spared EGDs and HRV missed. A total of 741 consecutive patients were included in the final analysis. Of them, 576 patients were included in the training cohort and 165 patients in the validation cohort. In the training cohort, ARP strategy was defined as LSM < 1.805 m/s or SSM < 2.445 m/s and PLT > 110 × 109/L. ARP strategy could spare 234 (40.6%) EGDs with a missed HRV rate of 3.4% (8 of 234). In the validation cohort, compared with Baveno VI criteria, the ARP strategy improved the proportion of avoided EGDs (49.7% vs. 34.5%; p < 0.001) and lowered the rate of misclassified HRV (1.2% vs. 3.5%; p < 0.001). Conclusion: The ARP strategy was an efficient and safe tool for varices screening in compensated cirrhosis, and it might be an auxiliary or even alternative to Baveno VI criteria. |
| first_indexed | 2024-03-12T19:00:12Z |
| format | Article |
| id | doaj.art-483571294f64450e95e8b7a3a06577c7 |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-03-12T19:00:12Z |
| publishDate | 2022-11-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-483571294f64450e95e8b7a3a06577c72023-08-02T06:40:17ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2022-11-016113154316210.1002/hep4.2076A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteriaYifei HuangLili Zhao0Ruiling He1Shuang Li2Chuan Liu3Xiaolong Qi4Jia Li5Department of Gastroenterology and Hepatology Tianjin Second People's Hospital Tianjin ChinaInstitute of Portal Hypertension The First Hospital of Lanzhou University Lanzhou ChinaDepartment of Gastroenterology and Hepatology Tianjin Second People's Hospital Tianjin ChinaCenter of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School Southeast University Nanjing ChinaInstitute of Portal Hypertension The First Hospital of Lanzhou University Lanzhou ChinaDepartment of Gastroenterology and Hepatology Tianjin Second People's Hospital Tianjin ChinaAbstract Few studies have reported on acoustic radiation force impulse (ARFI) for varices screening. Our study aimed to identify a strategy based on liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) by ARFI combined with platelet count (PLT), named the ARP strategy, for ruling out high‐risk varices (HRV) and avoiding unnecessary esophagogastroduodenoscopy (EGD) in patients with compensated cirrhosis. We retrospectively reviewed patients who underwent ARFI from a previous cohort (NCT04307264). Of them, patients between 2017 and 2019 composed the training cohort to develop the ARP strategy. The validation cohort consisted of others between 2015 and 2016 to validate and compare it with Baveno VI criteria about the performance for varices screening. Primary outcomes were the rates of spared EGDs and HRV missed. A total of 741 consecutive patients were included in the final analysis. Of them, 576 patients were included in the training cohort and 165 patients in the validation cohort. In the training cohort, ARP strategy was defined as LSM < 1.805 m/s or SSM < 2.445 m/s and PLT > 110 × 109/L. ARP strategy could spare 234 (40.6%) EGDs with a missed HRV rate of 3.4% (8 of 234). In the validation cohort, compared with Baveno VI criteria, the ARP strategy improved the proportion of avoided EGDs (49.7% vs. 34.5%; p < 0.001) and lowered the rate of misclassified HRV (1.2% vs. 3.5%; p < 0.001). Conclusion: The ARP strategy was an efficient and safe tool for varices screening in compensated cirrhosis, and it might be an auxiliary or even alternative to Baveno VI criteria.https://doi.org/10.1002/hep4.2076 |
| spellingShingle | Yifei Huang Lili Zhao Ruiling He Shuang Li Chuan Liu Xiaolong Qi Jia Li A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteria Hepatology Communications |
| title | A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteria |
| title_full | A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteria |
| title_fullStr | A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteria |
| title_full_unstemmed | A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteria |
| title_short | A strategy for varices screening based on acoustic radiation force impulse combined with platelet (CHESS2001): An alternative of Baveno VI criteria |
| title_sort | strategy for varices screening based on acoustic radiation force impulse combined with platelet chess2001 an alternative of baveno vi criteria |
| url | https://doi.org/10.1002/hep4.2076 |
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