• Fuquan Liu, Zhenyuan Ning, Yanna Liu, Dengxiang Liu, Jie Tian, Hongwu Luo, Weimin An, Yifei Huang, Jialiang Zou, Chuan Liu, Changchun Liu, Lei Wang, Zaiyi Liu, Ruizhao Qi, Changzeng Zuo, Qingge Zhang, Jitao Wang, Dawei Zhao, Yongli Duan, Baogang Peng, Xingshun Qi, Yuening Zhang, Yongping Yang, Jinlin Hou, Jiahong Dong, Zhiwei Li, Huiguo Ding, Yu Zhang, and Xiaolong Qi.
• CHESS Group, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
• EBioMedicine. 2018 Oct 1; 36: 151-158.

AbstractClinically significant portal hypertension (CSPH) is associated with an incremental risk of esophageal varices and overt clinical decompensations. However, hepatic venous pressure gradient (HVPG) measurement, the gold standard for defining CSPH (HVPG≥10 mm Hg) is invasive and therefore not suitable for routine clinical practice. This study aims to develop and validate a radiomics-based model as a noninvasive method for accurate detection of CSPH in cirrhosis. The prospective multicenter diagnostic trial (CHESS1701, ClinicalTrials.gov identifier: NCT03138915) involved 385 patients with cirrhosis from five liver centers in China between August 2016 and September 2017. Patients who had both HVPG measurement and contrast-enhanced CT within 14 days prior to the catheterization were collected. The noninvasive radiomics model, termed rHVPG for CSPH was developed based on CT images in a training cohort consisted of 222 consecutive patients and the diagnostic performance was prospectively assessed in 163 consecutive patients in four external validation cohorts. rHVPG showed a good performance in detection of CSPH with a C-index of 0·849 (95%CI: 0·786-0·911). Application of rHVPG in four external prospective validation cohorts still gave excellent performance with the C-index of 0·889 (95%CI: 0·752-1·000, 0·800 (95%CI: 0·614-0·986), 0·917 (95%CI: 0·772-1·000), and 0·827 (95%CI: 0·618-1·000), respectively. Intraclass correlation coefficients for inter- and intra-observer agreement were 0·92-0·99 and 0·97-0·99, respectively. A radiomics signature was developed and prospectively validated as an accurate method for noninvasive detection of CSPH in cirrhosis. The tool of rHVPG assessment can facilitate the identification of CSPH rapidly when invasive transjugular procedure is not available.Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

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