NEW QUALITY CRITERIA FOR TRANSIENT ELASTROGRAPHY CAN INCREASE THE PROPORTION OF VALID MEASUREMENTS WITH HIGH ACCURACY FOR DETECTION OF LIVER CIRRHOSIS AND PORTAL HYPERTENSION

P1038 NEW QUALITY CRITERIA FOR TRANSIENT ELASTROGRAPHY CAN INCREASE THE PROPORTION OF VALID MEASUREMENTS WITH HIGH ACCURACY FOR DETECTION OF LIVER CIRRHOSIS AND PORTAL HYPERTENSION P. Schwabl, S. Bota, P. Salzl, M. Mandorfer, B.-A. Payer, A. Ferlitsch, J. Stift, F. Wrba, M. Trauner, M. Peck-Radosavljevic, T. Reiberger, Vienna Hepatic Hemodynamic Lab. Dept. of Internal Medicine III, Div. of Gastroenterology & Hepatology, Medical University Vienna, Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria E-mail: philipp.schwabl@meduniwien.ac.at Background and Aims: Recently, new quality criteria for transient elastography (TE) measurements have been proposed (Boursier et. al. Hepatology 2013): very reliable: IQR/M 0.3 if TE 0.3 if TE >7.1 kPa. We evaluated the diagnostic power and accuracy of TE measurements according to these new quality criteria (accurate = very reliable + reliable) for non-invasive assessment of liver fibrosis (liver biopsy) and portal hypertension (HVPG). Methods: Patients undergoing TE, HVPG measurement and liver biopsy within 3 months at a tertiary care were retrospectively identified. Results: Among 278 patients (48.7±13.1 years, 74.7% male, 75.7% viral etiology, 57% F3/F4), traditional TE quality criteria identified 71.6% reliable measurements, while new criteria yielded in 83.2% accurate LS measurements (23.1% very reliable, 60.1% reliable). Reliable TE values according to traditional or new criteria were all significantly and similarly strong correlated with fibrosis stage (R =0.648 vs. R = 0.636) and HVPG (R=0.836 vs. R = 0.846). The accuracy for diagnosing liver cirrhosis (F4, cut-off: 14.5 kPa) was 76.5% and 75.0% for traditional and new TE criteria, respectively. The positive (PPV) and negative (NPV) values for new criteria at the 14.5 kPa cut-off were 83% and 70%. For predicting HVPG ≥10mmHg (cut-off: 16.1 kPa), the accuracies were 88.9% and 89.8% using traditional or new criteria, respectively. Both criteria resulted in AUCs for diagnosis of HVPG ≥10mmHg of over 0.95 with a PPV and NPV of 76% and 97%, respectively. Conclusions: Applying new quality criteria for TE measurements significantly increases the number of valid TE measurements without affecting accuracy of TE for diagnosis of liver cirrhosis and portal hypertension.