Which is better at estimating severe liver fibrosis, hepatic reserve capacity scoring or splenic volumetry?

Research Square (Research Square)(2023)

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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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