Clinical application of liver stiffness measurement using transient elastography in chronic liver disease from longitudinal perspectives

Figure 1 Cumulative incidences of variceal bleeding based on liver stiffness-spleen diameter to platelet ratio score values. A: The incidence of variceal bleeding increased significantly in association with higher liver stiffness-spleen diameter to platelet ratio score (LSPS) values (long-rank test, P < 0.001); B: In particular, among patients with high risk esophageal varices (EV), the incidence of variceal bleeding was significantly higher in patient with LSPS 6.5 (subgroup 2) than those with LSPS < 6.5 (subgroup 1).

Figure 2 Cumulative incidence of hepatocellular carcinoma development based on stratified transient elastography values in patients with chronic hepatitis C (A, n = 866) and those with chronic hepatitis B (B, n = 1130). The cumulative incidences increased significantly in association with higher TE values (log-rank test, all P < 0.001). In particular, the overall incidence of HCC differed significantly among the four groups (C) (both initial and follow-up TE values ≤ 13 kPa (group 1), initial TE value > 13 kPa and follow-up TE value ≤ 13 kPa (group 2), initial TE value ≤ 13 kPa and follow-up TE value > 13 kPa (group 3), and both initial and follow-up TE values > 13 kPa (group 4) according to changing patterns of TE value during follow-up (P < 0.001; Figure 2C). A: Cited from Masuzaki et al[52]; B and C: Cited from Jung et al[53]. HCC: Hepatocellular carcinoma; TE: Transient elastography; LSM: Liver stiffness measurement.

Figure 3 Incidence of liver-related events according to changes in transient elastography values after 6 mo of antiviral therapy. The overall incidence of liver-related events differed significantly among the four groups using TE value cutoffs of 11.6 kPa (A) and 18.2 kPa (B) (both P < 0.0001). Adapted from Kim et al[79]. TE: Transient elastography; LSM: Liver stiffness measurement; LREs: Liver-related events.