The Value of Follow-Up Liver Stiffness Changes Measured by Virtual Touch Quantification Elastography for Predicting Recurrence of Gastroesophageal Varices after Endoscopic Injection Sclerotherapy on Cirrhotic Patients

TL;DR

This study shows that tracking liver stiffness changes after a treatment for gastroesophageal varices can help predict if the condition will return.

Contribution

The study introduces liver stiffness trends as a potential low-cost predictor for recurrence of gastroesophageal varices after sclerotherapy.

Findings

Liver stiffness remained elevated in patients with recurrence of varices.

Non-recurrence patients showed decreasing liver stiffness over time.

Liver stiffness changes had a significant predictive value with an AUC of 0.806.

Abstract

Recurrence of gastroesophageal varices (GEVs) after sclerotherapy is a public health problem. However, mass screening of recurrence of GEVs through gastroscopy is a high-cost procedure. We aim to evaluate the changes in liver stiffness (LS) over time after endoscopic injection sclerotherapy (EIS) and determine its value in predicting the recurrence of GEVs.

One hundred and thirty-five patients with GEVs who underwent EIS treatment were included in this study. The patients were divided into two groups, namely, the nonrecurrence and recurrence groups, based on endoscopic findings at 6 months after discharge. LS measurements were obtained on five occasions. Repeated measure analysis of variance was employed to assess LS differences at different time points and compare them between the two groups.

The LS values during the 6-month postdischarge period were consistently higher than the baseline value (measured on the day of hospitalization). The recurrence group demonstrated sustained elevated LS levels throughout the 6-month follow-up period, while the nonrecurrence group showed a gradual decline in LS. The difference in LS trend between the two groups was statistically significant (P = 0.04). The area under the curve (AUC) values for LS differences were 0.806, with a corresponding 95% confidence interval (CI) of 0.640-0.918 and a cut-off value of 0.556, indicating their potential utility in predicting GEV recurrence.

Longitudinal assessment of LS values in post-EIS patients can provide valuable information for predicting the recurrence of GEVs.

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