---
OA_place: publisher
OA_type: hybrid
_id: '21839'
abstract:
- lang: eng
text: "Background & Aims: To develop and validate a CT-based radiomics model to
assess HVPG and predict a composite endpoint of liver-related events (LRE: decompensation
and liver-related death) in patients with cirrhosis.\r\n\r\nMethods: This retrospective
study included 357 cirrhosis patients, who received invasive HVPG measurements,
120 liver-healthy controls (training cohort) and 85 and 100 cirrhosis patients
(internal and external validation cohorts, respectively), and contrast-enhanced
abdominal CTs. After volumetric segmentation of the liver and spleen on CT, Bayesian
parameter optimization was used for selection of extracted features and hyperparameter
tuning in random forest or elastic net models. Prediction accuracy was evaluated
using Pearson correlation coefficients of predicted (’radio-HVPG’) and invasive
HVPG. Discrimination between relevant HVPG cut-offs was determined by receiver
operating characteristic (ROC) analysis. The predictive value of radio-HVPG and
invasive-HVPG for LRE was compared using Cox regression models.\r\n\r\nResults:
Radio-HVPG, predicted by an optimized random forest model based on 74 selected
CT features, correlated with invasive-HVPG and detected clinically significant
portal hypertension (CSPH: HVPG ≥ 10 mmHg) on the internal (Pearson r = 0.63,
AUC 0.89 [95% CI: 0.81–0.96]) and external (Pearson r = 0.62, AUC 0.80 [95% CI:
0.64–0.91]) validation cohorts. Radio-HVPG predicted LRE when adjusting for MELD
and albumin (adjusted HR: 1.14 [95% CI: 1.04–1.25], p = 0.005) and performed similarly
to invasive-HVPG.\r\n\r\nConclusions: Radiomic features accurately predict HVPG
in patients with cirrhosis and allow risk stratification for LRE in a radiomics-clinical
signature."
acknowledgement: "The computational results presented were partly obtained using the
CLIP cluster (https://clip.science/). The authors thank Clemens Watzenboeck from
the Medical University of Vienna for the assistance in code upload and repository
maintenance. The authors dedicate this work to the memory of Martin Watzenboeck,
who served as first author and whose vision and scientific rigor were fundamental
to the conception and completion of this study. Open Access funding provided by
Medizinische Universitat Wien/KEMÖ. This work was supported by the Vienna Science
and Technology Fund (WWTF) through projects VRG15-005 and NXT 19-008 granted to
J.M and the Clinical Research Group MOTION, Medical University of Vienna, Vienna,
Austria – a Clinical Research Group Programme project funded by the Ludwig Boltzmann
Gesellschaft (Grant Nr LBG_KFG_22_32) with funds from the Fonds Zukunft Österreich.\r\n\r\nP-E.R.'s
research laboratory is supported by the Fondation pour la Recherche Médicale (FRM
EQU202303016287), “Institut National de la Santé et de la Recherche Médicale” (ATIP
AVENIR), the “Agence Nationale de la Recherche” (ANR-18-CE14-0006-01, RHU QUID-NASH,
ANR-18-IDEX-0001, ANR-22-CE14-0002) by « Émergence, Ville de Paris », by Fondation
ARC, by the European Union's Horizon 2020 research and innovation programme under
grant agreement No 847949 and by France 2030 RHU LIVER-TRACK."
article_number: e70633
article_processing_charge: Yes (via OA deal)
article_type: original
author:
- first_name: Celine
full_name: Sin, Celine
last_name: Sin
- first_name: Martin Luther
full_name: Watzenboeck, Martin Luther
last_name: Watzenboeck
- first_name: Eugenia B
full_name: Iofinova, Eugenia B
id: f9a17499-f6e0-11ea-865d-fdf9a3f77117
last_name: Iofinova
orcid: 0000-0002-7778-3221
- first_name: Lorenz
full_name: Balcar, Lorenz
last_name: Balcar
- first_name: Georg
full_name: Semmler, Georg
last_name: Semmler
- first_name: Bernhard
full_name: Scheiner, Bernhard
last_name: Scheiner
- first_name: Katharina
full_name: Lampichler, Katharina
last_name: Lampichler
- first_name: Mattias
full_name: Mandorfer, Mattias
last_name: Mandorfer
- first_name: Lucile
full_name: Moga, Lucile
last_name: Moga
- first_name: Pierre‐Emmanuel
full_name: Rautou, Pierre‐Emmanuel
last_name: Rautou
- first_name: Maxime
full_name: Ronot, Maxime
last_name: Ronot
- first_name: Jörg
full_name: Menche, Jörg
last_name: Menche
- first_name: Thomas
full_name: Reiberger, Thomas
last_name: Reiberger
- first_name: Martina
full_name: Scharitzer, Martina
last_name: Scharitzer
citation:
ama: Sin C, Watzenboeck ML, Iofinova EB, et al. Radiomics‐based assessment of portal
hypertension severity and risk stratification of cirrhotic patients using routine
CT scans. Liver International. 2026;46(5). doi:10.1111/liv.70633
apa: Sin, C., Watzenboeck, M. L., Iofinova, E. B., Balcar, L., Semmler, G., Scheiner,
B., … Scharitzer, M. (2026). Radiomics‐based assessment of portal hypertension
severity and risk stratification of cirrhotic patients using routine CT scans.
Liver International. Wiley. https://doi.org/10.1111/liv.70633
chicago: Sin, Celine, Martin Luther Watzenboeck, Eugenia B Iofinova, Lorenz Balcar,
Georg Semmler, Bernhard Scheiner, Katharina Lampichler, et al. “Radiomics‐based
Assessment of Portal Hypertension Severity and Risk Stratification of Cirrhotic
Patients Using Routine CT Scans.” Liver International. Wiley, 2026. https://doi.org/10.1111/liv.70633.
ieee: C. Sin et al., “Radiomics‐based assessment of portal hypertension severity
and risk stratification of cirrhotic patients using routine CT scans,” Liver
International, vol. 46, no. 5. Wiley, 2026.
ista: Sin C, Watzenboeck ML, Iofinova EB, Balcar L, Semmler G, Scheiner B, Lampichler
K, Mandorfer M, Moga L, Rautou P, Ronot M, Menche J, Reiberger T, Scharitzer M.
2026. Radiomics‐based assessment of portal hypertension severity and risk stratification
of cirrhotic patients using routine CT scans. Liver International. 46(5), e70633.
mla: Sin, Celine, et al. “Radiomics‐based Assessment of Portal Hypertension Severity
and Risk Stratification of Cirrhotic Patients Using Routine CT Scans.” Liver
International, vol. 46, no. 5, e70633, Wiley, 2026, doi:10.1111/liv.70633.
short: C. Sin, M.L. Watzenboeck, E.B. Iofinova, L. Balcar, G. Semmler, B. Scheiner,
K. Lampichler, M. Mandorfer, L. Moga, P. Rautou, M. Ronot, J. Menche, T. Reiberger,
M. Scharitzer, Liver International 46 (2026).
date_created: 2026-05-07T08:51:47Z
date_published: 2026-05-01T00:00:00Z
date_updated: 2026-05-18T07:20:20Z
day: '01'
ddc:
- '570'
doi: 10.1111/liv.70633
external_id:
pmid:
- '41943460'
file:
- access_level: open_access
checksum: fafcc0b88b8e8caed85849627305d9ba
content_type: application/pdf
creator: dernst
date_created: 2026-05-18T07:10:31Z
date_updated: 2026-05-18T07:10:31Z
file_id: '21888'
file_name: 2026_LiverInternational_Sin.pdf
file_size: 3550462
relation: main_file
success: 1
file_date_updated: 2026-05-18T07:10:31Z
has_accepted_license: '1'
intvolume: ' 46'
issue: '5'
keyword:
- computed tomography
- liver
- portal hypertension
- radiomics
- spleen
language:
- iso: eng
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
month: '05'
oa: 1
oa_version: Published Version
pmid: 1
publication: Liver International
publication_identifier:
eissn:
- 1478-3231
issn:
- 1478-3223
publication_status: published
publisher: Wiley
quality_controlled: '1'
scopus_import: '1'
status: public
title: Radiomics‐based assessment of portal hypertension severity and risk stratification
of cirrhotic patients using routine CT scans
tmp:
image: /images/cc_by_nc_nd.png
legal_code_url: https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode
name: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
(CC BY-NC-ND 4.0)
short: CC BY-NC-ND (4.0)
type: journal_article
user_id: 2DF688A6-F248-11E8-B48F-1D18A9856A87
volume: 46
year: '2026'
...