Similar performance of liver stiffness measurement and liver surface nodularity for the detection of portal hypertension in patients with hepatocellular carcinoma

ABSTRACT Background & Aims To compare the performance of liver surface nodularity (LSN) and liver stiffness measurements (LSM) using transient elastography (TE) for the detection of clinically significant portal hypertension (CSPH) in patients with cirrhosis and hepatocellular carcinoma (HCC). Materials All patients with cirrhosis and HCC who underwent computed tomography (CT), LSM and hepatic venous pressure gradient (HVPG) measurements within 30 days between 2015-2018 were included. The estimation of CSPH by LSN, LSM, and the LSM-spleen-size-to-platelet-ratio score (LSPS) were evaluated and compared. Results 140 patients were included (109 men [78%], mean age 63±9 years-old), including 39 (28%) with CSPH. LSN measurements were valid in 130 patients (93%) and significantly correlated with the HVPG (r=0.68; P Conclusion The diagnostic performance and feasibility of LSN measurements were similar to those of LSM for the detection of CSPH in patients with compensated cirrhosis and HCC. Combining LSN and LSPS accurately detects CSPH in more than 75% of patients. This could be useful in centers where the HVPG measurement is unavailable.