A novel model to predict esophageal varices in patients with compensated cirrhosis using acoustic radiation force impulse elastography

Yehyun Park, Seungup Kim, Soo Young Park, Beom Kyung Kim, Junyong Park, doyoung kim, SangHoon Ahn, Won Young Tak, Young Oh Kweon, KwangHyub Han

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background & Aims: Few noninvasive methods can accurately identify esophageal varices (EVs) in patients with compensated cirrhosis. We developed and validated a novel, acoustic radiation force impulse (ARFI) elastography-based prediction model for high-risk EVs (HEVs) in patients with compensated cirrhosis. Methods: A total of 143 patients with compensated cirrhosis between February, 2010 and February, 2013 (training set) and 148 between June, 2010 and May, 2013 (validation set) who underwent ARFI elastography and endoscopy were prospectively recruited. Independent predictors of HEVs were used to construct a prediction model. Results: Based on multivariate analysis, we developed two new statistical models, a varices risk score and ARFI-spleen diameter-to-platelet ratio score (ASPS), the latter of which was calculated as ARFI velocity x spleen diameter/platelet count. The area under receiver operating characteristic curve (AUROC) of the varices risk score and ASPS to predict HEVs were 0.935 (95% confidence interval [CI] 0.882-0.970) and 0.946 (95% CI 0.895-0.977), respectively. When ASPS, a simpler model with a higher AUROC, was applied in the validation set, acceptable diagnostic accuracy for HEVs was observed (AUROC = 0.814 [95% CI 0.743 -0.885]). To detect HEVs, a negative predictive value of 98.3%was achieved at ASPS <2.83, whereas a positive predictive value of 100% was achieved at ASPS >5.28. Conclusions: ASPS, a novel noninvasive ARFI-based prediction model, can accurately identify HEVs in patients with compensated cirrhosis. ASPS <2.83 may safely rule out the presence of HEVs, whereas patients with ASPS >5.28 should be considered for endoscopic examinations or appropriate prophylactic treatment.

Original languageEnglish
Article numbere0121009
JournalPLoS One
Volume10
Issue number3
DOIs
Publication statusPublished - 2015 Mar 31

Fingerprint

Elasticity Imaging Techniques
Esophageal and Gastric Varices
Acoustics
acoustics
Fibrosis
Radiation
ROC Curve
confidence interval
Varicose Veins
Confidence Intervals
Platelets
prediction
spleen
Spleen
Endoscopy
blood platelet count
endoscopy
Statistical Models
statistical models
Platelet Count

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{7c0a50732ad44ec6b33e045608042d0b,
title = "A novel model to predict esophageal varices in patients with compensated cirrhosis using acoustic radiation force impulse elastography",
abstract = "Background & Aims: Few noninvasive methods can accurately identify esophageal varices (EVs) in patients with compensated cirrhosis. We developed and validated a novel, acoustic radiation force impulse (ARFI) elastography-based prediction model for high-risk EVs (HEVs) in patients with compensated cirrhosis. Methods: A total of 143 patients with compensated cirrhosis between February, 2010 and February, 2013 (training set) and 148 between June, 2010 and May, 2013 (validation set) who underwent ARFI elastography and endoscopy were prospectively recruited. Independent predictors of HEVs were used to construct a prediction model. Results: Based on multivariate analysis, we developed two new statistical models, a varices risk score and ARFI-spleen diameter-to-platelet ratio score (ASPS), the latter of which was calculated as ARFI velocity x spleen diameter/platelet count. The area under receiver operating characteristic curve (AUROC) of the varices risk score and ASPS to predict HEVs were 0.935 (95{\%} confidence interval [CI] 0.882-0.970) and 0.946 (95{\%} CI 0.895-0.977), respectively. When ASPS, a simpler model with a higher AUROC, was applied in the validation set, acceptable diagnostic accuracy for HEVs was observed (AUROC = 0.814 [95{\%} CI 0.743 -0.885]). To detect HEVs, a negative predictive value of 98.3{\%}was achieved at ASPS <2.83, whereas a positive predictive value of 100{\%} was achieved at ASPS >5.28. Conclusions: ASPS, a novel noninvasive ARFI-based prediction model, can accurately identify HEVs in patients with compensated cirrhosis. ASPS <2.83 may safely rule out the presence of HEVs, whereas patients with ASPS >5.28 should be considered for endoscopic examinations or appropriate prophylactic treatment.",
author = "Yehyun Park and Seungup Kim and Park, {Soo Young} and Kim, {Beom Kyung} and Junyong Park and doyoung kim and SangHoon Ahn and Tak, {Won Young} and Kweon, {Young Oh} and KwangHyub Han",
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A novel model to predict esophageal varices in patients with compensated cirrhosis using acoustic radiation force impulse elastography. / Park, Yehyun; Kim, Seungup; Park, Soo Young; Kim, Beom Kyung; Park, Junyong; kim, doyoung; Ahn, SangHoon; Tak, Won Young; Kweon, Young Oh; Han, KwangHyub.

In: PLoS One, Vol. 10, No. 3, e0121009, 31.03.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A novel model to predict esophageal varices in patients with compensated cirrhosis using acoustic radiation force impulse elastography

AU - Park, Yehyun

AU - Kim, Seungup

AU - Park, Soo Young

AU - Kim, Beom Kyung

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Tak, Won Young

AU - Kweon, Young Oh

AU - Han, KwangHyub

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Y1 - 2015/3/31

N2 - Background & Aims: Few noninvasive methods can accurately identify esophageal varices (EVs) in patients with compensated cirrhosis. We developed and validated a novel, acoustic radiation force impulse (ARFI) elastography-based prediction model for high-risk EVs (HEVs) in patients with compensated cirrhosis. Methods: A total of 143 patients with compensated cirrhosis between February, 2010 and February, 2013 (training set) and 148 between June, 2010 and May, 2013 (validation set) who underwent ARFI elastography and endoscopy were prospectively recruited. Independent predictors of HEVs were used to construct a prediction model. Results: Based on multivariate analysis, we developed two new statistical models, a varices risk score and ARFI-spleen diameter-to-platelet ratio score (ASPS), the latter of which was calculated as ARFI velocity x spleen diameter/platelet count. The area under receiver operating characteristic curve (AUROC) of the varices risk score and ASPS to predict HEVs were 0.935 (95% confidence interval [CI] 0.882-0.970) and 0.946 (95% CI 0.895-0.977), respectively. When ASPS, a simpler model with a higher AUROC, was applied in the validation set, acceptable diagnostic accuracy for HEVs was observed (AUROC = 0.814 [95% CI 0.743 -0.885]). To detect HEVs, a negative predictive value of 98.3%was achieved at ASPS <2.83, whereas a positive predictive value of 100% was achieved at ASPS >5.28. Conclusions: ASPS, a novel noninvasive ARFI-based prediction model, can accurately identify HEVs in patients with compensated cirrhosis. ASPS <2.83 may safely rule out the presence of HEVs, whereas patients with ASPS >5.28 should be considered for endoscopic examinations or appropriate prophylactic treatment.

AB - Background & Aims: Few noninvasive methods can accurately identify esophageal varices (EVs) in patients with compensated cirrhosis. We developed and validated a novel, acoustic radiation force impulse (ARFI) elastography-based prediction model for high-risk EVs (HEVs) in patients with compensated cirrhosis. Methods: A total of 143 patients with compensated cirrhosis between February, 2010 and February, 2013 (training set) and 148 between June, 2010 and May, 2013 (validation set) who underwent ARFI elastography and endoscopy were prospectively recruited. Independent predictors of HEVs were used to construct a prediction model. Results: Based on multivariate analysis, we developed two new statistical models, a varices risk score and ARFI-spleen diameter-to-platelet ratio score (ASPS), the latter of which was calculated as ARFI velocity x spleen diameter/platelet count. The area under receiver operating characteristic curve (AUROC) of the varices risk score and ASPS to predict HEVs were 0.935 (95% confidence interval [CI] 0.882-0.970) and 0.946 (95% CI 0.895-0.977), respectively. When ASPS, a simpler model with a higher AUROC, was applied in the validation set, acceptable diagnostic accuracy for HEVs was observed (AUROC = 0.814 [95% CI 0.743 -0.885]). To detect HEVs, a negative predictive value of 98.3%was achieved at ASPS <2.83, whereas a positive predictive value of 100% was achieved at ASPS >5.28. Conclusions: ASPS, a novel noninvasive ARFI-based prediction model, can accurately identify HEVs in patients with compensated cirrhosis. ASPS <2.83 may safely rule out the presence of HEVs, whereas patients with ASPS >5.28 should be considered for endoscopic examinations or appropriate prophylactic treatment.

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