{
  "abstract": "Background and Aims: The applicability of non‐invasive tests (NITs) for clinically significant portal hypertension (CSPH) in patients with hepatocellular carcinoma (HCC) is controversial. We performed a head‐to‐head comparison of various NITs for CSPH and evaluated rule‐in/‐out criteria.\n\nMethods: We conducted a retrospective study including 283 patients with HCC undergoing hepatic venous pressure gradient (HVPG) measurement at the Vienna Hepatic Haemodynamic Lab with available, same‐day data on NITs (i.e., liver stiffness measurement [LSM], platelet count [PLT], von Willebrand factor antigen [VWF:Ag], and the ratio of VWF:Ag and PLT [VITRO]). For the subsequent analysis, we focused on patients with compensated advanced chronic liver disease (cACLD).\n\nResults: Among 164 patients with cACLD, most were BCLC 0/A (50.6%) and CSPH prevalence was 46.3%, the median LSM was 20.0 kPa (IQR: 13.3–37.9), and mean VWF:Ag/VITRO was 266 ± 119%/2.30 ± 1.81. The VITRO score yielded the highest discriminative ability to detect CSPH (AUROC: 0.834), followed by ANTICIPATE ± NASH (AUROC: 0.822), PLT (AUROC: 0.803), LSM (AUROC: 0.779), and VWF:Ag (AUROC: 0.707). The application of the Baveno VII criterium (LSM ≤ 15 kPa & PLT ≥ 150G/L) and the VITRO score (≤ 1.0) individually showed an excellent performance for ruling‐out CSPH (sensitivities: ≥ 95%, NPV: 100%/87.9%). For ruling‐in CSPH by individual criteria, the VITRO score provided the highest PPV (≥ 2.5, specificity/PPV: 89.8%/83.0%), followed by the Baveno VII criteria (specificity/PPV: 81.8%/74.6%). When sequentially applying Baveno VII criteria and VITRO, the grey zone could be significantly reduced to 16% (sensitivity/NPV: 94.7%/92.2%; specificity/PPV: 73.9%/84.4%).\n\nConclusion: The discriminative ability in patients with cACLD and HCC was comparable to patients without HCC. However, PPVs of established criteria were < 90%, which may be explained by the comparatively low prevalence of CSPH in this context.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Gastroenterology and Hepatology, Department of Medicine III Medical University of Vienna Vienna Austria",
    "Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Medicine III Medical University of Vienna Vienna Austria",
    "Clinical Research Group MOTION Medical University of Vienna Vienna Austria",
    "Department of General Surgery Medical University of Vienna Vienna Austria",
    "Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery Mayo Clinic Rochester Minnesota USA",
    "Department of Laboratory Medicine Medical University of Vienna Vienna Austria"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Lorenz Balcar",
      "orcid": "0000-0002-6708-3061"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Tina Jasmin Haunold"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Mathias Jachs",
      "orcid": "0000-0003-2871-4147"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Georg Semmler",
      "orcid": "0000-0002-0411-166X"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Benedikt Simbrunner",
      "orcid": "0000-0001-8181-9146"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Albert Friedrich Stättermayer",
      "orcid": "0000-0003-0737-4091"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "David Pereyra",
      "orcid": "0000-0001-6700-9163"
    },
    {
      "affs": [
        3
      ],
      "name": "Christoph Schwarz"
    },
    {
      "affs": [
        3
      ],
      "name": "Stefan Stremitzer",
      "orcid": "0000-0002-4815-4135"
    },
    {
      "affs": [
        3
      ],
      "name": "Klaus Kaczirek",
      "orcid": "0000-0003-2156-4377"
    },
    {
      "affs": [
        4
      ],
      "name": "Patrick Starlinger"
    },
    {
      "affs": [
        5
      ],
      "name": "Peter Quehenberger",
      "orcid": "0000-0002-0122-8213"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Michael Trauner"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Bernhard Scheiner",
      "orcid": "0000-0002-4904-5133"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Thomas Reiberger",
      "orcid": "0000-0002-4590-3583"
    },
    {
      "affs": [
        0
      ],
      "name": "Matthias Pinter",
      "orcid": "0000-0002-7260-532X"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Mattias Mandorfer",
      "orcid": "0000-0003-2330-0017"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8gvbv50gxbk81.bib",
  "cited_by": 0,
  "doi": "10.1111/liv.70947",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696973/",
  "id": "8gvbv50gxbk81",
  "issns": [
    "1478-3223",
    "1478-3231"
  ],
  "landing_url": "https://doi.org/10.1111/liv.70947",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2721|Liver Disease and Transplantation"
    ]
  ],
  "openalex": "W7223703417",
  "pdf_url": "https://europepmc.org/articles/PMC13696973?pdf=render",
  "pmcid": "PMC13696973",
  "pmid": "42928966",
  "published": "2026-10-26",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8gvbv50gxbk81.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:14Z",
      "native_id": "PMC13696973",
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      "url": "https://doi.org/10.1111/liv.70947"
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    {
      "first_seen": "2026-10-30T12:21:18Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Liver Disease and Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Blood‐ and Liver Stiffness‐Based Non‐Invasive Tests for Clinically Significant Portal Hypertension in Patients With cACLD and HCC",
  "title_text": "Blood‐ and Liver Stiffness‐Based Non‐Invasive Tests for Clinically Significant Portal Hypertension in Patients With cACLD and HCC",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:34:13Z",
  "url": "https://research.draconitic.com/paper/8gvbv50gxbk81",
  "venue": "Liver International",
  "versions": []
}