Serum tests, liver stiffness and artificial neural networks for diagnosing cirrhosis and portal hypertension

Journal article

Authors / Editors

Agachi, Paul

Research Areas

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Publication Details

Author list: Procopet B, Cristea VM, Robic MA, Grigorescu M, Agachi PS, Metivier S, Peron JM, Selves J, Stefanescu H, Berzigotti A, Vinel JP, Bureau C

Publisher: Elsevier: 12 months

Place: NEW YORK

Publication year: 2015

Journal: Digestive and Liver Disease (1590-8658)

Journal acronym: DIGEST LIVER DIS

Volume number: 47

Issue number: 5

Start page: 411

End page: 416

Number of pages: 6

ISSN: 1590-8658

Languages: English-Great Britain (EN-GB)

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Abstract

Background: The diagnostic performance of biochemical scores and artificial neural network models for portal hypertension and cirrhosis is not well established.Aims: To assess diagnostic accuracy of six serum scores, artificial neural networks and liver stiffness measured by transient elastography, for diagnosing cirrhosis, clinically significant portal hypertension and oesophageal varices.Methods: 202 consecutive compensated patients requiring liver biopsy and hepatic venous pressure gradient measurement were included. Several serum tests (alone and combined into scores) and liver stiffness were measured. Artificial neural networks containing or not liver stiffness as input variable were also created.Results: The best non-invasive method for diagnosing cirrhosis, portal hypertension and oesophageal varices was liver stiffness (C-statistics = 0.93, 0.94, and 0.90, respectively). Among serum tests/scores the best for diagnosing cirrhosis and portal hypertension and oesophageal varices were, respectively, Fibrosis-4, and Lok score. Artificial neural networks including liver stiffness had high diagnostic performance for cirrhosis, portal hypertension and oesophageal varices (accuracy > 80%), but were not statistically superior to liver stiffness alone.Conclusions: Liver stiffness was the best non-invasive method to assess the presence of cirrhosis, portal hypertension and oesophageal varices. The use of artificial neural networks integrating different non-invasive tests did not increase the diagnostic accuracy of liver stiffness alone. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Keywords

HVPG, Liver biopsy, Non-invasive tests, Oesophageal varices, Serological scores, Transient elastography

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