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BioMed Research International
Volume 2014, Article ID 365982, 8 pages
http://dx.doi.org/10.1155/2014/365982
Clinical Study

A New Sampling Method for Spleen Stiffness Measurement Based on Quantitative Acoustic Radiation Force Impulse Elastography for Noninvasive Assessment of Esophageal Varices in Newly Diagnosed HCV-Related Cirrhosis

1Ultrasuoni Diagnostic Medical Center, 95100 Catania, Italy
2Department of Mathematics and Statistics “S. Vianelli”, University of Palermo, viale delle Scienze, 90128 Palermo, Italy
3Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Via Palermo 636, 95125 Catania, Italy
4Department of Medical Oncology, National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, Italy
5Euro-Mediterranean Institute of Science and Technology (IEMEST), Via Emerico Amari 123, 90139 Palermo, Italy
6Research Center “The Great Senescence”, University of Catania, 95125 Catania, Italy
7Radiological Diagnostic Center, “Euganea Medica”, 35100 Padova, Italy
8Division of Radiology, National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, Italy

Received 4 December 2013; Revised 20 January 2014; Accepted 23 January 2014; Published 4 March 2014

Academic Editor: Qing He

Copyright © 2014 Leonardo Rizzo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In our study, we evaluated the feasibility of a new sampling method for splenic stiffness (SS) measurement by Quantitative Acoustic Radiation Force Impulse Elastography (Virtual Touch Tissue Quantification (VTTQ)).We measured SS in 54 patients with HCV-related cirrhosis of whom 28 with esophageal varices (EV), 27 with Chronic Hepatitis C (CHC) F1–F3, and 63 healthy controls. VTTQ-SS was significantly higher among cirrhotic patients with EV (3.37 m/s) in comparison with controls (2.19 m/s, ), CHC patients (2.37 m/s, ), and cirrhotic patients without EV (2.7 m/s, ). Moreover, VTTQ-SS was significantly higher among cirrhotic patients without EV in comparison with both controls () and CHC patients (). The optimal VTTQ-SS cut-off value for predicting EV was 3.1 m/s (AUROC = 0.96, sensitivity 96.4%, specificity 88.5%, positive predictive value 90%, negative predictive value 96%, positive likelihood ratio 8.36, and negative likelihood ratio 0.04). In conclusion, VTTQ-SS is a promising noninvasive and reliable diagnostic tool to screen cirrhotic patients for EV and reduce the need for upper gastrointestinal endoscopy. By using our cut-off value of 3.1 m/s, we would avoid endoscopy in around 45% of cirrhotic subjects, with significant time and cost savings.