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Quantification of liver extracellular volume using dual-energy CT for ruling out high-risk varices in cirrhosis.

Authors
  • Hong, Seokjin1
  • Kim, Ji Eun2
  • Cho, Jae Min1
  • Choi, Ho Cheol1
  • Won, Jung Ho1
  • Na, Jae Beom1
  • Choi, Dae Seob1
  • Park, Mi Jung1
  • Choi, Hye Young1
  • Shin, Hwa Seon1
  • Cho, Hyun Chin3
  • Kim, Hyun Ok4
  • 1 Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. , (North Korea)
  • 2 Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. Electronic address: [email protected] , (North Korea)
  • 3 Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. , (North Korea)
  • 4 Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea. , (North Korea)
Type
Published Article
Journal
European journal of radiology
Publication Date
Mar 01, 2022
Volume
148
Pages
110151–110151
Identifiers
DOI: 10.1016/j.ejrad.2022.110151
PMID: 35032849
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To determine the performance of quantification of liver extracellular volume fraction (fECV) using dual-energy CT (DECT) compared with CT imaging for ruling out high-riskesophageal varices(HRV) in cirrhotic patients. We retrospectively analyzed 229 cirrhotic patients (training [n = 159] and internal validation cohorts [n = 70]) who underwent dual-source DECT, serum marker assessment, and esophagogastroduodenoscopy (EGD) from 2017 to 2020. The fECV score was measured using iodine maps from 3-minute delayed, equilibrium-phase images at 100/140 Sn kVp. The association of CT parameters and serum markers with HRV was investigated. Criteria combining the fECV score (≤ 25.1%) or CT imaging with platelet count (> 150,000/mm3) were created and compared to rule out HRV. In the training cohort, the fECV score (odds ratio (OR), 1.20; 95% confidence interval (CI), 1.09, 1.32) and CT imaging (OR, 28.21; 95% CI, 9.31, 85.93) were independent predictors of HRV, along with platelet count (OR, 0.85 and 0.78). Criteria combining the fECV score with platelet count showed significantly better performance than those combining CT imaging with platelet count in ruling out HRV (p < 0.001). Applying the criteria could have safely avoided an additional 10.7% and 8.6% of EGDs in the training and validation cohorts, respectively, achieving a final value of 36.5% and 35.7% spared EGDs (0 HRV missed) compared to CT imaging with platelet count. The combined DECT-based fECV score with platelet count is useful for ruling out HRV and can safely avoid more EGDs than CT imaging with platelet count. Copyright © 2022. Published by Elsevier B.V.

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