Role of spleen elastography in patients with chronic liver diseases

Table 1 Diagnostic performance of liver stiffness and spleen stiffness for liver fibrosis and esophageal varices[20]

	F≥2 (66%)		F = 4 (23%)		EV (10%)
	L-TE	S-TE	L-TE	S-TE	L-TE	S-TE
Cut-off (kPa)	8	36	12	46	19	65
Sensitivity	83 (54-76)	76 (61-81)	92 (80-100)	89 (72-99)	73 (59-93)	91 (81-100)
Specificity	65 (76-98)	80 (65-93)	80 (72-89)	78 (82-96)	47 (34-68)	80 (65-94)
LR+	2.4	3.9	4.6	4.5	1.4	4.5
LR-	0.2	0.3	0.09	0.1	0.5	0.1
AUROC	0.85 (0.78-0.92)	0.80 (0.65-0.85)	0.93 (0.88-0.96)	0.84 (0.76-0.93)	0.62 (0.41-0.89)	0.90 (0.79-100)

TE: Transient elastography; EV: Esophageal varices.

Table 2 Primary studies assessing the role of spleen elastography in the staging of liver severe fibrosis/cirrhosis

Ref.	Technique	Cut-off	Patients	Sens	Spec	LR+	LR-	PPV	NPV	AUROC
Chen et al[29], 2012 (prospective)	ARFI	3.32	163	80.0	88.4	6.9	0.23	55.5	96.0	0.93 (0.89-0.97)
Fraquelli et al[20], 2013 (prospective)	TE	46.00	110	89.0	78.0	4.5	0.10	54.7	95.0	0.84 (0.76-0.92)
Cabassa et al[30], 2015 (prospective)	ARFI	3.05	51	73.0	84.0	4.5	0.32	91.0	77.0	0.80 (0.68-0.93)
Bota et al[28], 2010 (prospective)	ARFI	2.51	67	85.2	91.7	10.2	0.16	73.3	87.1	0.910
Grgurevic et al[39], 2015 (prospective)	RT-2D SWE	24.00	66	66.7	86.7	5.01	0.38	75.0	81.3	0.821

ARFI: Acoustic radiation force impulse; AUROC: Area under receiver operative curves; LR+: Likelihood ratio positive; LR-: Likelihood ratio negative; RT 2D-SWE: Real-time two-dimensional shear-wave elastography; TE: Transient elastography; PPV: Positive predictive value; NPV: Negative predictive value.

Table 3 Primary studies assessing the role of spleen elastography for the detection of esophageal varices

Ref.	Technique	Cut-off	n	Prevalence	Sens	Spec	LR+	LR-	PPV	NPV	AUROC
Stefanescu et al[75], 2011 (prospective)	TE	46.4	174	85%	83.5	71.0	2.90	0.23	93.8	45.5	0.780
Hirooka et al[74], 2011 (prospective)	RT-SWE	8.24	60	43%	96.0	85.0	6.40	0.04	83.0	97.0	0.91 (0.873-0.99)
Bota et al[85], 2012 (prospective)	ARFI	2.55	140	43%	96.7	21.0	18.00	0.15	47.6	89.4	0.578
Colecchia et al[64], 2012 (prospective)	TE	55.00	100	53%	71.7	96.0	17.00	0.29	95.3	75.2	0.941 (0.90-0.98)
Vermehren et al[86], 2012 (prospective)	ARFI	4.13	166	36%	35.0	83.0	2.06	0.78	54.0	69.0	0.58 (0.49-0.67)
Calvaruso et al[21], 2013 (prospective)	TE	50.00	96	56%	65.0	61.0	1.70	0.60	69.0	57.0	0.701
Fraquelli et al[20], 2013 (prospective)	TE	48.00	26	42%	100.0	60.0	2.50	0.01	33.5	98.7	0.90 (0.79-1.00)
Sharma et al[76], 2013 (prospective)	TE	40.80	200	71%	94.0	76.0	3.90	0.08	91.0	84.0	0.89 (0.84-0.95)
Takuma et al[87], 2013 (prospective)	ARFI	3.18	340	38.8%	98.5	60.1	2.46	0.02	61.0	98.4	0.93 (0.90-0.96)
Takuma et al[88], 2016 (prospective)	ARFI	3.36	60	40%	95.4	77.8	4.31	0.05	74.2	96.6	0.93 (0.84-0.98)

ARFI: Acoustic radiation force impulse; AUROC: Area under receiver operative curves; LR+: Likelihood ratio positive; LR-: Likelihood ratio negative; RT 2D-SWE = Real-time two-dimensional shear-wave elastography; TE: Transient elastography; PPV: Positive predictive value; NPV: Negative predictive value.