Shingo Kihira1, Alexander C Kagen2, Prasanna Vasudevan3, Guido H Jajamovich1, Thomas D Schiano4, Anne-Fleur Andrle5, James S Babb6, Aaron Fischman3, Bachir Taouli7,8. 1. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA. 2. Mount Sinai St. Luke's and Mount Sinai Roosevelt Hospitals, 1111 Amsterdam Ave, New York, NY, 10025, USA. 3. Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, 1470 Madison Avenue, New York, NY, 10029, USA. 4. Division of Liver Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. 5. Olea Medical, 1955 Massachusetts Ave, Suite 14, Cambridge, MA, 02140, USA. 6. Department of Radiology, NYU Langone Medical Center, New York, NY, 10016, USA. 7. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA. bachir.taouli@mountsinai.org. 8. Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, 1470 Madison Avenue, New York, NY, 10029, USA. bachir.taouli@mountsinai.org.
Abstract
PURPOSE: To assess the diagnostic value of a fast scoring system based on non-invasive cross-sectional imaging to predict portal hypertension (PH) in patients with liver disease. METHODS: In this retrospective study, we included patients who underwent contrast-enhanced CT or MRI within 3 months of hepatic venous pressure gradient (HVPG) measurements. Two independent observers provided an imaging-based scoring system (max of 9): number of variceal sites, volume of ascites, and spleen size. ROC analysis was performed to predict the presence of PH (HVPG ≥ 5 mmHg) and clinically significant PH (HVPG ≥ 10 mmHg). RESULTS: Our cohort consists of 143 patients with mean HVPG of 13.1 ± 2.0 mmHg. Mean PH scores from the two observers were 3.9 ± 2.7 and 3.2 ± 2.5. There was a significant correlation between PH score and HVPG (r = 0.58, p < 0.001 for both observers) with high inter-observer agreement (kappa 0.71). AUCs of 0.78-0.76 and 0.83-0.81 were observed for diagnosing HVPG ≥ 5 mmHg and HVPG ≥ 10 mmHg, respectively, for observers 1 and 2. CONCLUSIONS: We have developed a fast PH imaging-based composite score, which could be used for non-invasive detection of clinically significant PH.
PURPOSE: To assess the diagnostic value of a fast scoring system based on non-invasive cross-sectional imaging to predict portal hypertension (PH) in patients with liver disease. METHODS: In this retrospective study, we included patients who underwent contrast-enhanced CT or MRI within 3 months of hepatic venous pressure gradient (HVPG) measurements. Two independent observers provided an imaging-based scoring system (max of 9): number of variceal sites, volume of ascites, and spleen size. ROC analysis was performed to predict the presence of PH (HVPG ≥ 5 mmHg) and clinically significant PH (HVPG ≥ 10 mmHg). RESULTS: Our cohort consists of 143 patients with mean HVPG of 13.1 ± 2.0 mmHg. Mean PH scores from the two observers were 3.9 ± 2.7 and 3.2 ± 2.5. There was a significant correlation between PH score and HVPG (r = 0.58, p < 0.001 for both observers) with high inter-observer agreement (kappa 0.71). AUCs of 0.78-0.76 and 0.83-0.81 were observed for diagnosing HVPG ≥ 5 mmHg and HVPG ≥ 10 mmHg, respectively, for observers 1 and 2. CONCLUSIONS: We have developed a fast PH imaging-based composite score, which could be used for non-invasive detection of clinically significant PH.