Spleen stiffness measurement (SSM) by TE can be used in cACLD due to viral hepatitis (untreated HCV; untreated and treated HBV) to rule out and rule in CSPH (SSM <21 kPa and SSM >50 kPa, respectively). Validation of the best cut-off using a 100 Hz specific TE-probe, as well as using point-shear wave elastography and 2D-shear wave elastography is needed.
In patients who are not candidates for NSBBs (contraindication/intolerance) and in whom endoscopy would be required according to the Baveno VI criteria (LSM by TE ≥20 kPa or platelet count ≤150x109L), SSM ≤40 kPa by TE can be used to identify those at low probability of high-risk varices, in whom endoscopy can be avoided.
References:
Corrigendum to ‘Baveno VII – Renewing consensus in portal hypertension’ [J Hepatol (2022) 959-974] Journal of Hepatology, Vol. 77, Issue 2