Which is better at estimating severe liver fibrosis, hepatic reserve capacity scoring or splenic volumetry?
Research Square (Research Square)(2023)
Abstract
Abstract We aimed to assess liver and splenic volumetry (LV and SV), extracellular-volume (ECV) on dual-layer-spectral-detector CT (DLCT) and scoring-systems identifying liver fibrosis (LF). In 45 patients with pathologically staged LF, ECV measured on CT value (HU-ECV), iodine-density (ID-ECV), atomic-number (Zeff-ECV), and electron-density (ED-ECV) were calculated by two-readers. LV or SV/body-surface-area (BSA), albumin-bilirubin-grade (ALBI), model-for-end-stage-liver-disease-score (MELD), aspartate-aminotransferase-platelet-ratio-index (APRI), and fibrosis-index-based-on-the-four-factors (FIB-4) were also recorded. ALBI was weakly associated with LF (p = 0.451), while MELD (p < 0.001), APRI (p = 0.010), and FIB-4 (p = 0.010) were significantly associated with LF. SV/BSA had a higher AUC than MELD, APRI, and FIB-4 for estimating > F4 (AUC = 0.815,95%-CI = 0.63–0.999), but MELD (AUC = 0.799,95%-CI = 0.634–0.965), APRI (AUC = 0.722,95%-CI = 0.561–0.883), and FIB-4 (AUC = 0.741,95%-CI = 0.582–0.899) had higher AUCs than SV/BSA. SV/BSA significantly contributed to differentiation between F0–3 and F4; the odds ratio (OR) was 1.304 (Reader1;R1) and 1.353 (Reader2;R2), whereas MELD significantly contributed to the differentiation between F0–2 and F3–4; the OR was 1.528 (R1) and 1.509 (R2). AUC for SV/BSA and MELD combined was 0.877 (95%-CI = 0.748–1.000). In conclusion, SV/BSA allows for higher estimation of liver-cirrhosis (≥ F4). MELD is more suitable for assessing severe LF (≥ F3-4). The combination of SV/BSA and MELD had a higher AUC than SV/BSA alone for liver-cirrhosis (≥ F4).
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Key words
hepatic reserve capacity scoring,splenic volumetry,liver fibrosis,severe liver fibrosis
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