Non-invasive measurement of HVPG using graph analysis based on dynamic contrast-enhanced ultrasound with ESAOTE MyLab: The CLEVER Study

Background and aims: Non-invasive methods accurately estimating hepatic venous pressure gradient (HVPG) are un unmet clinical need. Preliminary data suggested that graph analysis of dynamic contrast enhanced ultrasonography (DCE-US) of the liver using a “connectome” approach allows assessment of the liver microcirculatory derangement and mirrors the severity of portal hypertension (Amat-Roldan et al. Radiology 2015). The EC-funded prospective CLEVER study (FP7-IAPP-GA-2013-612273-CLEVER) is aimed at developing a novel automatized software based on DCE-US able to improve prognostication in cirrhosis. First extended results were developed with a Siemens Acuson Sequoia in Barcelona, showing optimal correlation with HVPG. Here we report the adaptation of this CLEVER software to DCE-US videos acquired with ESAOTE MyLab equipments in Bologna to predict HVPG in a population of patients with F≥3 hepatopathy.