title: Non-invasive prediction of portal pressures using CT and MRI in chronic liver disease.
abstract: OBJECTIVE
  To assess the diagnostic value of a fast scoring system based on non-invasive cross-sectional imaging to predict portal hypertension (PH) in patients with liver disease.
  
  
  METHODS
  In this retrospective study, we included patients who underwent contrast-enhanced CT or MRI within 3 months of hepatic venous pressure gradient (HVPG) measurements. Two independent observers provided an imaging-based scoring system (max of 9): number of variceal sites, volume of ascites, and spleen size. ROC analysis was performed to predict the presence of PH (HVPG ≥ 5 mmHg) and clinically significant PH (HVPG ≥ 10 mmHg).
  
  
  RESULTS
  Our cohort consists of 143 patients with mean HVPG of 13.1 ± 2.0 mmHg. Mean PH scores from the two observers were 3.9 ± 2.7 and 3.2 ± 2.5. There was a significant correlation between PH score and HVPG (r = 0.58, p < 0.001 for both observers) with high inter-observer agreement (kappa 0.71). AUCs of 0.78-0.76 and 0.83-0.81 were observed for diagnosing HVPG ≥ 5 mmHg and HVPG ≥ 10 mmHg, respectively, for observers 1 and 2.
  
  
  CONCLUSIONS
  We have developed a fast PH imaging-based composite score, which could be used for non-invasive detection of clinically significant PH.
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kihira
authors.affiliation: Mount Sinai St. Luke's and Mount Sinai Roosevelt Hospitals, 1111 Amsterdam Ave, New York, NY, 10025, USA.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Kagen
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, 1470 Madison Avenue, New York, NY, 10029, USA.
authors.forename: Prasanna
authors.initials: P
authors.lastname: Vasudevan
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA.
authors.forename: Guido H
authors.initials: GH
authors.lastname: Jajamovich
authors.affiliation: Division of Liver Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Schiano
authors.affiliation: Olea Medical, 1955 Massachusetts Ave, Suite 14, Cambridge, MA, 02140, USA.
authors.forename: Anne-Fleur
authors.initials: AF
authors.lastname: Andrle
authors.affiliation: Department of Radiology, NYU Langone Medical Center, New York, NY, 10016, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, 1470 Madison Avenue, New York, NY, 10029, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Fischman
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA. bachir.taouli@mountsinai.org.|Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, 1470 Madison Avenue, New York, NY, 10029, USA. bachir.taouli@mountsinai.org.
authors.forename: Bachir
authors.initials: B
authors.lastname: Taouli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: CT; Cirrhosis; Hepatic venous pressure gradient; MRI; Portal hypertension