title: A new sampling method for spleen stiffness measurement based on quantitative acoustic radiation force impulse elastography for noninvasive assessment of esophageal varices in newly diagnosed HCV-related cirrhosis.
abstract: In our study, we evaluated the feasibility of a new sampling method for splenic stiffness (SS) measurement by Quantitative Acoustic Radiation Force Impulse Elastography (Virtual Touch Tissue Quantification (VTTQ)).We measured SS in 54 patients with HCV-related cirrhosis of whom 28 with esophageal varices (EV), 27 with Chronic Hepatitis C (CHC) F1-F3, and 63 healthy controls. VTTQ-SS was significantly higher among cirrhotic patients with EV (3.37 m/s) in comparison with controls (2.19 m/s, P<0.001), CHC patients (2.37 m/s, P<0.001), and cirrhotic patients without EV (2.7 m/s, P<0.001). Moreover, VTTQ-SS was significantly higher among cirrhotic patients without EV in comparison with both controls (P<0.001) and CHC patients (P<0.01). The optimal VTTQ-SS cut-off value for predicting EV was 3.1 m/s (AUROC=0.96, sensitivity 96.4%, specificity 88.5%, positive predictive value 90%, negative predictive value 96%, positive likelihood ratio 8.36, and negative likelihood ratio 0.04). In conclusion, VTTQ-SS is a promising noninvasive and reliable diagnostic tool to screen cirrhotic patients for EV and reduce the need for upper gastrointestinal endoscopy. By using our cut-off value of 3.1 m/s, we would avoid endoscopy in around 45% of cirrhotic subjects, with significant time and cost savings.
authors.affiliation: Ultrasuoni Diagnostic Medical Center, 95100 Catania, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Rizzo
authors.affiliation: Department of Mathematics and Statistics "S. Vianelli", University of Palermo, viale delle Scienze, 90128 Palermo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Attanasio
authors.affiliation: Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Via Palermo 636, 95125 Catania, Italy.
authors.forename: Marilia Rita
authors.identifier: 0000-0001-6764-567X
authors.initials: MR
authors.lastname: Pinzone
authors.affiliation: Department of Medical Oncology, National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, Italy ; Euro-Mediterranean Institute of Science and Technology (IEMEST), Via Emerico Amari 123, 90139 Palermo, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.affiliation: Research Center "The Great Senescence", University of Catania, 95125 Catania, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Malaguarnera
authors.affiliation: Radiological Diagnostic Center, "Euganea Medica", 35100 Padova, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Morra
authors.affiliation: Department of Mathematics and Statistics "S. Vianelli", University of Palermo, viale delle Scienze, 90128 Palermo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: L'Abbate
authors.affiliation: Division of Radiology, National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Balestreri
authors.affiliation: Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Via Palermo 636, 95125 Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nunnari
authors.affiliation: Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Via Palermo 636, 95125 Catania, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Cacopardo
mesh_terms: D000368:Aged; D000465:Algorithms; D003627:Data Interpretation, Statistical; D055119:Elastic Modulus; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D018401:Sample Size; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013314:Stress, Mechanical; D014463:Ultrasonography
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