Journal article
Validation of the Baveno VI criteria to rule out high-risk varices using hepatic shear-wave elastography
European journal of gastroenterology & hepatology, Vol.35(5), pp.559-567
05/01/2023
DOI: 10.1097/MEG.0000000000002507
PMID: 36966754
Abstract
Introduction and objectives
Liver stiffness measurement (LSM) by transient elastography has been validated to predict high-risk varices (HRV). We aimed to evaluate the accuracy of shear-wave elastography (SWE) and platelet count (Baveno VI criteria) to rule out HRV in patients with compensated advanced chronic liver disease (c-ACLD).
Methods
This retrospective study analyzed data of patients with c-ACLD (transient elastography ≥ 10 kPa) submitted to two-dimensional SWE (2D-SWE) (GE-LOGIQ-S8) and/or point SWE (p-SWE) (ElastPQ) who had a gastrointestinal endoscopy within 24 months. HRV definition was a large size and presence of red wale marks or sequelae from previous treatment. Optimal thresholds of SWE systems for HRV were identified. The proportion of spared gastrointestinal endoscopies and missing HRV considering a favorable SWE Baveno VI criteria were assessed.
Results
Eighty patients [36% male, median age = 63 (interquartile range, 57–69) years] were included. The prevalence of HRV was 34% (n = 27/80). The optimal thresholds to predict HRV were 10 kPa and 12 kPa for 2D-SWE and p-SWE, respectively. A favorable 2D-SWE Baveno VI criteria (LSM < 10 kPa and platelets count > 150 × 109/mm3) avoided 19% of gastrointestinal endoscopies without missing HRVs. A favorable p-SWE Baveno VI criteria (LSM < 12 kPa and platelets count > 150 × 109/mm3) spared 20% of gastrointestinal endoscopy without missing HRVs. Using a lower threshold of platelet count (<110 × 109/mm3, expanded Baveno VI), 2D-SWE (<10 kPa) avoided 33% of gastrointestinal endoscopy with 8% of missing HRVs, while p-SWE (<12 kPa) avoided 36% of gastrointestinal endoscopy with 5% of missing HRVs.
Conclusion
LSM by p-SWE or 2D-SWE combined with platelet count (Baveno VI criteria) can spare a considerable number of gastrointestinal endoscopies missing a negligible proportion of HRV.
Details
- Title: Subtitle
- Validation of the Baveno VI criteria to rule out high-risk varices using hepatic shear-wave elastography
- Creators
- Élio C. Castro Filho - National Institute of Infectious DiseasesFlávia F. Fernandes - Hospital Geral de BonsucessoCristiane Villela-Nogueira - Universidade Federal do Rio de JaneiroEduardo Madeira - Hospital Geral de BonsucessoFernando Barros - National Institute of Infectious DiseasesRodrigo Luz - Universidade Federal do Rio de JaneiroGustavo Henrique Pereira - Hospital Geral de BonsucessoHugo Perazzo - Fundação Oswaldo Cruz
- Resource Type
- Journal article
- Publication Details
- European journal of gastroenterology & hepatology, Vol.35(5), pp.559-567
- DOI
- 10.1097/MEG.0000000000002507
- PMID
- 36966754
- NLM abbreviation
- Eur J Gastroenterol Hepatol
- ISSN
- 0954-691X
- eISSN
- 1473-5687
- Number of pages
- 9
- Grant note
- E-26/201.351/2021 / Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (http://data.elsevier.com/vocabulary/SciValFunders/501100004586) 88882.443006/2019-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (http://data.elsevier.com/vocabulary/SciValFunders/501100002322)
- Language
- English
- Date published
- 05/01/2023
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985221144402771
Metrics
2 Record Views