Authors:	Armandi, Angelo Merizian, Talal Werner, Merle Marie Coxson, Harvey O. Sanavia, Tiziana Birolo, Giovanni Gashaw, Isabella Ertle, Judith Michel, Maurice Galle, Peter R. Labenz, Christian Emrich, Tilman Schattenberg, Jörn M.
Title:	Variability of transient elastography-based spleen stiffness performed at 100 Hz
Online publication date:	16-Jan-2024
Year of first publication:	2023
Language:	english
Abstract:	Background Spleen stiffness measurement (SSM) performed by transient elastography at 100 Hz is a novel technology for the evaluation of portal hypertension in advanced chronic liver disease, but technical aspects are lacking. We aimed to evaluate the intraexamination variability of SSM and to determine the best transient elastography protocol for obtaining robust measurements to be used in clinical practice. Methods We analyzed 253 SSM exams with up to 20 scans for each examination, performed between April 2021 and June 2022. All SSM results were evaluated according to different protocols by dividing data into groups of n measurements (from 2 to 19). Considering as reference the median SSM values across all the 20 measurements, we calculated the distribution of the absolute deviations of each protocol from the reference median. This analysis was repeated 1,000 times by resampling the data. Distributions were also stratified by etiology (chronic liver disease versus clinically significant portal hypertension) and different SSM ranges: < 25 kPa, 25–75, and > 75 kPa. Results Overall, we observed that the spleen stiffness exam had less variability if it exceeded 12 measurements, i.e., absolute deviations ≤ 5 kPa at 95% confidence. For exams with higher SSM values (> 75 kPa), as seen in clinically significant portal hypertension, at least 15 measurements are highly recommendable. Conclusions Fifteen scans per examination should be considered for each SSM exam performed at 100 Hz to achieve a low intraexamination variability within a reasonable time in clinical practice.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9916
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	European radiology experimental 7
Pages or article number:	79
Publisher:	Springer International Publishing
Publisher place:	Dordrecht u.a.
Issue date:	2023
ISSN:	2509-9280
Publisher DOI:	10.1186/s41747-023-00393-2
Appears in collections:	DFG-491381577-G