Similar performance of liver stiffness measurement and liver surface nodularity for the detection of portal hypertension in patients with hepatocellular carcinoma
Alexandra Souhami,
Riccardo Sartoris,
Pierre-Emmanuel Rautou,
François Cauchy,
Mohamed Bouattour,
François Durand,
Valerio Giannelli,
Elia Gigante,
Laurent Castera,
Dominique Valla,
Olivier Soubrane,
Valérie Vilgrain,
Maxime Ronot
Affiliations
Alexandra Souhami
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Riccardo Sartoris
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Pierre-Emmanuel Rautou
Service d'Hépatologie, DHU Unity, DMU Digest, Hôpital Beaujon, AP-HP, Clichy, France; Université de Paris, Centre de Recherche sur l'Inflammation, Inserm, U1149, CNRS, ERL8252, F-75018 Paris, France; Centre de Référence des Maladies Vasculaires du Foie, French Network for Rare Liver Diseases (FILFOIE), European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Clichy, France
François Cauchy
Department of Hepatobiliary Surgery, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Mohamed Bouattour
Service d'Hépatologie, DHU Unity, DMU Digest, Hôpital Beaujon, AP-HP, Clichy, France
François Durand
Service d'Hépatologie, DHU Unity, DMU Digest, Hôpital Beaujon, AP-HP, Clichy, France; Université de Paris, Centre de Recherche sur l'Inflammation, Inserm, U1149, CNRS, ERL8252, F-75018 Paris, France
Valerio Giannelli
Service d'Hépatologie, DHU Unity, DMU Digest, Hôpital Beaujon, AP-HP, Clichy, France
Elia Gigante
Service d'Hépatologie, DHU Unity, DMU Digest, Hôpital Beaujon, AP-HP, Clichy, France
Laurent Castera
Service d'Hépatologie, DHU Unity, DMU Digest, Hôpital Beaujon, AP-HP, Clichy, France
Dominique Valla
Service d'Hépatologie, DHU Unity, DMU Digest, Hôpital Beaujon, AP-HP, Clichy, France; Université de Paris, Centre de Recherche sur l'Inflammation, Inserm, U1149, CNRS, ERL8252, F-75018 Paris, France
Olivier Soubrane
Department of Hepatobiliary Surgery, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Valérie Vilgrain
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; Université de Paris, Centre de Recherche sur l'Inflammation, Inserm, U1149, CNRS, ERL8252, F-75018 Paris, France; INSERM U1149, CRI, Paris, France
Maxime Ronot
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; Université de Paris, Centre de Recherche sur l'Inflammation, Inserm, U1149, CNRS, ERL8252, F-75018 Paris, France; INSERM U1149, CRI, Paris, France; Corresponding author. Address: Department of Radiology, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France. Tel.: +33 1 4087 5566, Fax: +33 1 4087 4421.
Background & Aims: We compare the performance of liver surface nodularity (LSN) and liver stiffness measurements (LSM) using transient elastography (TE) for the detection of clinically significant portal hypertension (CSPH) in patients with cirrhosis and hepatocellular carcinoma (HCC). Methods: All patients with cirrhosis and HCC who underwent computed tomography, LSM and hepatic venous pressure gradient (HVPG) measurements within 30 days between 2015 and 2018 were included. The estimation of CSPH by LSN and LSM, and the LSM-spleen-size-to-platelet ratio score (LSPS) were evaluated and compared. Results: In total, 140 patients were included (109 men [78%], mean age 63 ± 9 years old), including 39 (28%) with CSPH. LSN measurements were valid in 130 patients (93%) and significantly correlated with HVPG (r = 0.68; p 75% of patients. Such a combination could be useful in centres where the HVPG measurement is unavailable. Lay summary: The diagnostic performance and feasibility of liver surface nodularity was similar to that of liver stiffness measurement (LSM) for the detection of clinically significant portal hypertension in patients with compensated cirrhosis. Thus, liver surface nodularity could be an option for the preoperative detection of clinically significant portal hypertension in patients with hepatocellular carcinoma. Combining liver surface nodularity with LSM-spleen-size-to-platelet ratio score resulted in the accurate detection of clinically significant portal hypertension in >75% of patients, thus limiting the need for HVPG measurements.
