Table 2.
Performance of liver surface nodularity, liver stiffness measurement, and LSPS for the diagnosis of clinically significant portal hypertension in the per-protocol population and in patients with HCC based on Milan Criteria.
| Criterion | AUROC | Cut-off values | Se (%) (95%CI) | Sp (%) (95%CI) | PPV (%) (95%CI) | NPV (%) (95%CI) | LR+ (%) (95%CI) | LR- (%) (95%CI) | No. correctly classified | |
|---|---|---|---|---|---|---|---|---|---|---|
| Per-protocol population (n = 122) | ||||||||||
| LSN | 0.871 ± 0.03 | Optimal∗ | >2.57 | 100 (91–100) | 63 (50–73) | 54 (44–61) | 100 (93–100) | 2.70 (1.82–3.70) | 0 (0–0.18) | 90/122 (74%) |
| Se ≥90% | >2.60 | 94 (77–99) | 66 (52–74) | 54 (41–67) | 97 (88–99) | 2.64 (1.0–3.81) | 0.09 (0.01–0.44) | 91/122 (75%) | ||
| Sp ≥90% | >2.96 | 60 (40–77) | 90 (81–95) | 70 (51–85) | 84 (75–91) | 6.00 (5.00–15.4) | 0.44 (0.24–0.74) | 98/122 (80%) | ||
| LSM | 0.825 ± 0.04 | Optimal∗ | >21.5 kPa | 68 (61–83) | 88 (80–93) | 70 (62–81) | 87 (78–94) | 3.09 (3.05–11.9) | 0.36 (0.18–0.49) | 97/122 (80%) |
| Se ≥90% | >13.7 kPa | 91 (77–98) | 63 (52–73) | 49 (37–62) | 93 (83–98) | 2.46 (1.60–3.63) | 0.14 (0.03–0.44) | 85/122 (70%) | ||
| Sp ≥90% | >33.0 kPa | 46 (29–63) | 91 (83–96) | 64 (43–82) | 79 (70–87) | 5.44 (4.14–15.8) | 0.59 (0.39–0.86) | 93 /122 (76%) | ||
| LSPS | 0.851 ± 0.04 | Optimal∗ | >1.34 | 75 (64–82) | 78 (69–86) | 59 (50–67) | 88 (81–94) | 3.40 (2.06–5.86) | 0.32 (0.21–0.52) | 95/122 (78%) |
| Se ≥90% | >0.88 | 91 (77–98) | 60 (49–71) | 49 (36–61) | 94 (85–99) | 2.28 (1.51–3.38) | 0.15 (0.03–0.47) | 84/122 (69%) | ||
| Sp ≥90% | >2.29 | 57 (39–74) | 91 (83–96) | 70 (51–85) | 84 (75–91) | 6.33 (2.29–18.5) | 0.47 (0.27–0.73) | 98/122 (80%) | ||
| Patients with HCC within Milan Criteria (n = 83) | ||||||||||
| LSN | 0.866 ± 0.04 | Optimal∗ | >2.57 | 100 (89–100) | 65 (52,77) | 63 (49–75) | 100 (90–100) | 2.22 (1.85–4.35) | 0 (0–0.21) | 65/83 (78%) |
| Se ≥90% | >2.66 | 92 (79–97) | 62 (47–75) | 67 (54–78) | 90 (75–97) | 2.42 (1.49–3.88) | 0.13 (0.04–0.45) | 63/83 (76%) | ||
| Sp ≥90% | >3.10 | 55 (38–71) | 90 (79–95) | 77 (65–86) | 77 (57–90) | 5.50 (1.81–14.2) | 0.50 (0.31–0.78) | 64/83 (77%) | ||
| LSM | 0.880 ± 0.04 | Optimal∗ | >21.0 kPa | 65 (47–79) | 90 (79–95) | 81 (69–89) | 80 (61–91) | 6.5 (2.23–15.8) | 0.39 (0.22–0.67) | 67/83 (81%) |
| Se ≥90% | >10.0 kPa | 90 (74–97) | 53 (40–66) | 51 (39–65) | 90 (75–97) | 1.91 (1.23–2.20) | 0.40 (0.05–0.90) | 55/83 (66%) | ||
| Sp ≥90% | >21.0 kPa | 65 (47–79) | 90 (79–95) | 81 (69–89) | 80 (61–91) | 6.5 (2.23–15.8) | 0.39 (0.22–0.67) | 67/83 (81%) | ||
| LSPS | 0.886 ± 0.04 | Optimal∗ | >1.38 | 74 (57–86) | 90 (79–95) | 82 (64–92) | 85 (73–92) | 7.40 (2.71–17.2) | 0.32 (0.15–0.54) | 69/83 (83%) |
| Se ≥90% | >0.86 | 92 (78–97) | 61 (46–74) | 64 (51–76) | 90 (75–97) | 2.24 (1.44–3.73) | 0.13 (0.04–0.48) | 61/83 (73%) | ||
| Sp ≥90% | >1.38 | 74 (57–86) | 90 (79–95) | 82 (64–92) | 85 (73–92) | 7.40 (2.71–17.2) | 0.32 (0.15–0.54) | 69/83 (83%) | ||
95% CI, 95% confidence interval; AUROC, area under receiver operating characteristic; LR+/−, positive/negative likelihood ratios; LSM, liver stiffness measurement; LSN, liver surface nodularity; LSPS, liver stiffness measurement-spleen-size-to-platelet ratio; PPV/NPV, positive/negative predictive value; Se/Sp, sensitivity/specificity.
∗
To maximise the Youden index.