Accuracy of Spleen Stiffness Measurement in Detection of Esophageal Varices in Patients With Chronic Liver Disease: Systematic Review and Meta-analysis

Singh, Siddharth; Eaton, John E.; Murad, M. Hassan; Tanaka, Hironori; Iijima, Hiroko; Talwalkar, Jayant A.

doi:10.1016/j.cgh.2013.09.013

Cited by 113 publications

(86 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The combination of LSM-TE and SSM shows the same NPV of 94% for large varices (22). As expected, an algorithm that takes into account these three results (LSM-TE, SSM, and the Lok Score) increased its performance, with an NPV of 100% for large varices (28), but this algorithm lacks external validation.…”

Section: Non-invasive Methods For the Detection Of Vntmentioning

confidence: 70%

“…Nevertheless, studies were highly heterogeneous and this made it difficult to establish a defined threshold value that could be used to triage patients not needing endoscopy. In the case of spleen stiffness measurement (SSM), a meta-analysis showed a suboptimal performance for the detection of VNT, with sensibility and specificity of 81% and 66%, respectively, but, again, there was a significant heterogeneity among studies (22). A meta-analysis (presented so far in abstract form) compared SSM and LSM for the detection of varices and evidenced a better performance of SSM with an AUR of 0.88 and 0.80, respectively (23).…”

Section: Non-invasive Methods For the Detection Of Vntmentioning

confidence: 99%

See 1 more Smart Citation

Non-invasive diagnosis of esophageal varices after Baveno VI

Velázquez

Abraldes²

2017

Turk J Gastroenterol

View full text Add to dashboard Cite

Section: Non-invasive Methods For the Detection Of Vntmentioning

confidence: 70%

Section: Non-invasive Methods For the Detection Of Vntmentioning

confidence: 99%

Non-invasive diagnosis of esophageal varices after Baveno VI

Velázquez

Abraldes²

2017

Turk J Gastroenterol

View full text Add to dashboard Cite

“…Similarly, in the meta-analysis of Singh et al (30) , they concluded that current techniques for measuring spleen stiffness are limited in their accuracy regarding large EV detection.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Liver and Spleen Stiffness by Fibroscan in Comparison to other Validated Indices for Non-Invasive Assessment of Esophageal Varices in Egyptian Patients with HCV-Related Cirrhosis

2016

Int. J. Adv. Res. Biol. Sci.

View full text Add to dashboard Cite

Background and Aim: Several investigators have devised non-invasive predictors for presence of esophageal varices (EV) in cirrhotic patients, thus avoiding unnecessary endoscopic screening. This work aimed at evaluating the role of liver and spleen stiffness measurements by Fibroscan in comparison to other validated indices for non-invasive assessment of EV in Egyptian patients with HCV-related cirrhosis. Methods and Material: This cross-sectional study included sixty patients with HCV-related cirrhosis who underwent complete clinical evaluation, laboratory investigations, abdominal ultrasonography, liver and spleen stiffness measurements (LSM and SSM) using Fibroscan and upper gastrointestinal endoscopy. Also, non-invasive predictive scores were calculated: AST-to-ALT ratio (AAR), platelet count/spleen diameter ratio (PSR) and AST-to-platelet ratio index (APRI). The diagnostic performance of each parameter was assessed using receiver operating characteristic (ROC) curves. Results: Patients were classified into two groups; Group 1: 33 patients (55%) with EV, and Group 2: 27 patients (45%) with no EV. There was a highly significant difference between the two groups regarding spleen diameter, PSR, APRI, LSM and SSM (P < 0.01). SSM showed a good performance as regards EV detection in comparison to LSM. At cut-off value ≥ 29 for SSM, sensitivity was 94.4%, specificity 86.4%, PPV 85% and NPV 95% (AUROC 0.934). Conclusion: Spleen stiffness measurement is a sensitive and reliable tool for detection of EV.

show abstract

“…Results of some studies showed that liver stiffness and spleen stiffness as measured by fibroscan is a predictor of esophageal varices in patients with liver cirrhosis [2]. However, a recently published meta-analysis showed that current methods for measuring spleen stiffness have limited accuracy for diagnosis of esophageal varices [3]. In the light of the results of this meta-analysis, routine measurement of liver and spleen stiffness for diagnosis of esophageal varices should be applied conservatively.…”

Section: To the Editormentioning

confidence: 99%