Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method.
<h4>Background</h4>Hepatic venous pressure gradient (HVPG) is the gold standard index for evaluating portal hypertension; however, measuring HVPG is invasive. Although transient elastography (TE) is the most common procedure for evaluating organ stiffness, accurate measurement of spleen...
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doaj-e33bd7dad93e4b2ba3cca173e45323de2021-07-29T04:32:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01162e024631510.1371/journal.pone.0246315Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method.Takaaki TanakaMasashi HirookaYohei KoizumiTakao WatanabeOsamu YoshidaYoshio TokumotoYoshiko NakamuraKoutarou SunagoAtsushi YukimotoMasanori AbeYoichi Hiasa<h4>Background</h4>Hepatic venous pressure gradient (HVPG) is the gold standard index for evaluating portal hypertension; however, measuring HVPG is invasive. Although transient elastography (TE) is the most common procedure for evaluating organ stiffness, accurate measurement of spleen stiffness (SS) is difficult. We developed a device to demonstrate the diagnostic precision of TE and suggest this technique as a valuable new method to measure SS.<h4>Methods</h4>Of 292 consecutive patients enrolled in this single-centre, translational, cross-sectional study from June through September in 2019, 200 underwent SS measurement (SSM) using an M probe (training set, n = 130; inspection set, n = 70). We performed TE with B-mode imaging using an ultrasound-fusion method, printed new devices with a three-dimensional printer, and attached the magnetic position sensor to the convex and M probes. We evaluated the diagnostic precision of TE to evaluate the risk of esophagogastric varices (EGVs).<h4>Results</h4>The median spleen volume was 245 mL (range, 64-1,720 mL), and it took 2 minutes to acquire a B-mode image using the ultrasound-fusion method. The median success rates of TE were 83.3% and 57.6% in patients with and without the new device, respectively (p<0.001); it was 76.9% and 35.0% in patients with and without splenomegaly (<100 mL), respectively (p<0.001). In the prediction of EGVs, the areas under the receiver operating characteristic curve were 0.921 and 0.858 in patients with and without the new device, respectively (p = 0.043). When the new device was attached, the positive and negative likelihood ratios were 3.44 and 0.11, respectively. The cut-off value of SSM was 46.0 kPa. Data that were similar between the validation and training sets were obtained.<h4>Conclusions</h4>The SS can be precisely measured using this new device with TE and ultrasound-fusion method. Similarly, we can estimate the bleeding risk due to EGV using this method.https://doi.org/10.1371/journal.pone.0246315 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Takaaki Tanaka Masashi Hirooka Yohei Koizumi Takao Watanabe Osamu Yoshida Yoshio Tokumoto Yoshiko Nakamura Koutarou Sunago Atsushi Yukimoto Masanori Abe Yoichi Hiasa |
spellingShingle |
Takaaki Tanaka Masashi Hirooka Yohei Koizumi Takao Watanabe Osamu Yoshida Yoshio Tokumoto Yoshiko Nakamura Koutarou Sunago Atsushi Yukimoto Masanori Abe Yoichi Hiasa Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method. PLoS ONE |
author_facet |
Takaaki Tanaka Masashi Hirooka Yohei Koizumi Takao Watanabe Osamu Yoshida Yoshio Tokumoto Yoshiko Nakamura Koutarou Sunago Atsushi Yukimoto Masanori Abe Yoichi Hiasa |
author_sort |
Takaaki Tanaka |
title |
Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method. |
title_short |
Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method. |
title_full |
Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method. |
title_fullStr |
Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method. |
title_full_unstemmed |
Development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method. |
title_sort |
development of a method for measuring spleen stiffness by transient elastography using a new device and ultrasound-fusion method. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2021-01-01 |
description |
<h4>Background</h4>Hepatic venous pressure gradient (HVPG) is the gold standard index for evaluating portal hypertension; however, measuring HVPG is invasive. Although transient elastography (TE) is the most common procedure for evaluating organ stiffness, accurate measurement of spleen stiffness (SS) is difficult. We developed a device to demonstrate the diagnostic precision of TE and suggest this technique as a valuable new method to measure SS.<h4>Methods</h4>Of 292 consecutive patients enrolled in this single-centre, translational, cross-sectional study from June through September in 2019, 200 underwent SS measurement (SSM) using an M probe (training set, n = 130; inspection set, n = 70). We performed TE with B-mode imaging using an ultrasound-fusion method, printed new devices with a three-dimensional printer, and attached the magnetic position sensor to the convex and M probes. We evaluated the diagnostic precision of TE to evaluate the risk of esophagogastric varices (EGVs).<h4>Results</h4>The median spleen volume was 245 mL (range, 64-1,720 mL), and it took 2 minutes to acquire a B-mode image using the ultrasound-fusion method. The median success rates of TE were 83.3% and 57.6% in patients with and without the new device, respectively (p<0.001); it was 76.9% and 35.0% in patients with and without splenomegaly (<100 mL), respectively (p<0.001). In the prediction of EGVs, the areas under the receiver operating characteristic curve were 0.921 and 0.858 in patients with and without the new device, respectively (p = 0.043). When the new device was attached, the positive and negative likelihood ratios were 3.44 and 0.11, respectively. The cut-off value of SSM was 46.0 kPa. Data that were similar between the validation and training sets were obtained.<h4>Conclusions</h4>The SS can be precisely measured using this new device with TE and ultrasound-fusion method. Similarly, we can estimate the bleeding risk due to EGV using this method. |
url |
https://doi.org/10.1371/journal.pone.0246315 |
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