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Liver stiffness measurement by acoustic radiation force impulse is useful in predicting the presence of esophageal varices or high-risk esophageal varices among patients with HCV-related cirrhosis

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

An Erratum to this article was published on 04 April 2015

Abstract

Background

Screening and periodic surveillance for esophageal varices (EVs) by esophagogastroduodenoscopy (EGD) are recommended for cirrhotic patients. We investigated non-invasive liver stiffness measurement using acoustic radiation force impulse (ARFI) for the diagnosis of EV presence and high-risk EVs among patients with HCV-related cirrhosis.

Methods

Among 181 consecutive patients with HCV-related cirrhosis, we studied 135 patients who had received EGD and ARFI. Serum fibrosis markers [platelet count, FIB-4, and aspartate aminotransferase-to-platelet ratio index (APRI)] were measured in a training set of 92 patients and compared with ARFI in the diagnostic performance for EV presence and high-risk EVs. Furthermore, the obtained optimal cutoff values of ARFI were prospectively examined in a validation set of 43 patients.

Results

In the training set, the ARFI value increased with the EV grade (p < 0.001). The ARFI value for high-risk EVs was significantly higher than that for low-risk EVs (p < 0.001). AUROC values for diagnosis of EV presence and high-risk EVs by ARFI were 0.890 and 0.868, which had the highest diagnostic performance among factors including serum fibrosis markers. The optimal cutoff value of ARFI for EV presence was 2.05 m/s with good sensitivity (83 %), specificity (76 %), PPV (78 %), and NPV (81 %), and that for high-risk EVs was 2.39 m/s with good sensitivity (81 %), specificity (82 %), PPV (69 %), and NPV (89 %). These cutoff values obtained in the training cohort also showed excellent performance in the validation set.

Conclusions

Liver stiffness measurement by ARFI is useful in predicting EV presence or high-risk EVs among patients with HCV-related cirrhosis.

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Acknowledgement

Dr. Kanto belongs to an endowed department sponsored by MSD. Dr. Takehara received donations from MSD and Chugai Pharmaceutical Co., Ltd.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Naoki Morishita, Naoki Hiramatsu, Tsugiko Oze, Naoki Harada, Ryoko Yamada, Masanori Miyazaki, Takayuki Yakushijin, Takuya Miyagi, Yuichi Yoshida, Tomohide Tatsumi & Tetsuo Takehara

  2. Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Ichikawa, Japan

    Tatsuya Kanto

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  1. Naoki Morishita
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  2. Naoki Hiramatsu
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Correspondence to Naoki Morishita.

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Morishita, N., Hiramatsu, N., Oze, T. et al. Liver stiffness measurement by acoustic radiation force impulse is useful in predicting the presence of esophageal varices or high-risk esophageal varices among patients with HCV-related cirrhosis. J Gastroenterol 49, 1175–1182 (2014). https://doi.org/10.1007/s00535-013-0877-z

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  • DOI: https://doi.org/10.1007/s00535-013-0877-z

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