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News
A noninvasive spleen stiffness test could safely eliminate the need for screening endoscopies in many patients with chronic portal vein thrombosis (PVT). A reading of 40 kPa or lower reliably ruled out high-risk, bleeding-prone varices — potentially sparing over 40% of endoscopies while missing high-risk cases in just 5% or fewer patients. The findings could meaningfully improve quality of life for this often-young patient population.
For patients with chronic portal vein thrombosis (PVT) and no cirrhosis, routine screening endoscopies are the current standard for detecting dangerous, bleeding-prone varices — but a new study suggests a simpler, noninvasive alternative may do the job just as well. Researchers found that spleen stiffness measurement (SSM) using vibration-controlled transient elastography (VCTE) could safely identify patients who don't need an endoscopy at all.
The multicenter retrospective study, conducted across 16 centers in Europe, Russia, and India, tested a spleen stiffness cutoff of 40 kPa in two separate patient cohorts. The cutoff correctly identified 97% of high-risk varice cases in the derivation group and 95% in the validation group — with a negative predictive value above 95% in both.
By the Numbers:
Why it matters: Patients with chronic noncirrhotic PVT are often young and face a lifetime of repeat endoscopies. A validated noninvasive test that can safely skip a large share of those procedures could significantly reduce patient burden and improve long-term quality of life.
