Prediction of oesophageal variceal bleeding by measuring spleen stiffness in patients with liver cirrhosis

Letter to the Editor We read with interest the guidelines by Tripathi et al 1 and the leading article by Rosselli et al ,2 reporting the role of transient elastography for the diagnosis of oesophageal varices (OV). Before screening endoscopy, non-invasive measures are needed to ascertain cirrhotic patients at high risk for oesophageal variceal bleeding (OVB) to decrease the number receiving unnecessary prophylactic treatments. In our recent study,3 spleen stiffness (SS) evaluated by acoustic radiation force impulse (ARFI) imaging was shown to be closely correlated with the presence of OV. This study aimed to evaluate SS determined by ARFI imaging as a predictor of OVB. We measured SS in 446 cirrhotic patients and followed them prospectively at Kurashiki Central Hospital between 2010 and 2014. We examined the diagnostic accuracy of SS for predicting OVB …