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World J Gastroenterol. Jan 21, 2019; 25(3): 308-329
Published online Jan 21, 2019. doi: 10.3748/wjg.v25.i3.308
Elastography-based screening for esophageal varices in patients with advanced chronic liver disease
Rafael Paternostro, Thomas Reiberger, Theresa Bucsics
Rafael Paternostro, Thomas Reiberger, Theresa Bucsics, Department of Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna A-1090, Austria
Author contributions: Paternostro R, Reiberger T, Bucsics T designed the review outline; Paternostro R, Bucsics T performed the literature research, Paternostro R, Bucsics T extracted the data from the literature search; Paternostro R, Reiberger T, Bucsics T wrote the paper.
Conflict-of-interest statement: Dr. Paternostro has nothing to disclose in regard to this manuscript. Dr. Reiberger received grants from Abbvie, grants, personal fees and other support from Boehringer-Ingelheim, grants and personal fees from Gore, grants, personal fees and other from Gilead, grants, personal fees and other from MSD, grants from Philips - all outside the submitted work. Dr. Bucsics received other support from Abbvie, personal fees and other from MSD, other from Bayer, grants from Austrian Society for Gastroenterology and Hepatology (ÖGGH) - all outside the submitted work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Thomas Reiberger, MD, Associate Professor, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Spitalgasse 23, Vienna, A-1090, Austria. thomas.reiberger@meduniwien.ac.at
Telephone: +43-140-40047410 Fax: +43-140-40047350
Received: October 10, 2018
Peer-review started: October 10, 2018
First decision: November 17, 2018
Revised: November 27, 2018
Accepted: December 19, 2018
Article in press: December 19, 2018
Published online: January 21, 2019
Core Tip

Core tip: Elastography-based measurement of liver stiffness (LSM) and spleen stiffness (SSM) represent valuable non-invasive screening tools for esophageal varices (EVs). Transient elastography (TE) has been widely validated, and the combined TE-based LSM < 20 kPa and platelet count (PLT) > 150 G/L algorithm is able to rule-out varices-needing-treatment (VNTs). While LSM and SSM by novel shear wave elastography devices and magnetic resonance elastography (MRE) may be more accurate to reflect the risk of EV and VNT, their value in clinical practice remains to be established.