Elastography-based screening for esophageal varices in patients with advanced chronic liver disease

Table 3 Two-dimensional shear wave elastography for the prediction of varices

Ref.	Country	Study design	Nr.	Etiology	Model	Cut-off (AUC) for EV	Sens/Spec/+LR/-LR/p for EV	Cut-off (AUC) for VNT	Se/Sp/+LR/-LR/p for VNT	Comment
Kim, Liver International, 2015[51]	Korea	Prospective	92	Mixed	Aixplorer	L-SWE: All patients: 26.3 kPa (0.683) Compensated cirrhosis: 14.2 kPa (0.925)	L-SWE: All patients: 61.4%/75.0%/PPV 89.6%/NPV 35.7%/P = 0.004 Compensated cirh.: 87.5%/90.0%/PPV 93.3%/NPV 81.8%/ P < 0.001	NR	NR	Main focus on prediction of PHT/CSPH
Grgurevic, Croatian Medical Journal 2015[53]	Croatia	Retrospective	44	Mixed	Aixplorer	L-SWE: 19.7 kPa (0.796) S-SWE: 30.3 kPa (0.790)	L-SWE: 83.3%/66.6%/2.5/0.25/0.037 S-SWE: 79.6%/75.8%/3.3/0.27/0.009	NR	NR
Kasai Journal of Medical Ultrasonics, 2015[54]	Japan	Retrospective	273	Mixed	Aixplorer	Cut-off: NR AUC: (0.807)	NR	NR	NR	No cut-offs or sensitivity analyses reported; varices: ≥ grade 2
Elkrief et al. Radiology 2015[56]	France	Prospective	79	Mixed	Aixplorer	NR	NR	NR	NR	EV not evaluated; Neither L-SWE, nor S-SWE, nor L-TE, nor LSPS predictive of VNT, but predictive of CSPH
Cassinotto, Digestive Liver Disease 2015[99]	France	Prospective	401	Mixed	Aixplorer	NR	NR	L-SWE: 12.8 (0.70) S-SWE: 25.6 (0.75)	L-SWE: 92%/36%/1.44/0.22/NR/PPV: 44%/NPV: 90% S-SWE: 94%/36%/1.47/0-17/NR/PPV:50%/NPV:90%
Kim et al. Journal of Ultrasound in Medicine 2016[55]	Korea	Retrospective	103	Mixed	Aixplorer	L-SWE: 13.9 kPa (0.887)	75%/88.9%/6.75/0.28/< 0.001	16.1 kPa (0.880)	84.6%/85.6%/5.86/0.18/< 0.001

AUC: Area under the (receiver operating) curve; CLD: Chronic liver disease; CSPH: Clinically significant portal hypertension; L-SWE: Liver shear wave elastography esophageal varices; TE: Transient elastography; Plt: Platelet count; VNT: Varices needing treatment; Se: Sensitivity; Sp: Specificity; +LR: Positive likelihood ratio; -LR: Negative likelihood ratio; NR: Not reported; S-SWE: Spleen share wave elastography.