The Accuracy of Variceal Detection in Computed Tomography Scans Compared to Esophagogastroduodenoscopy in a Tertiary Care Center: A Retrospective Review

Background Screening esophagogastroduodenoscopy (EGD) is recommended for all cirrhotic patients at the time of diagnosis, however, non-invasive screening practices for varices have been emerging. CT scans have demonstrated high sensitivity in the detection of esophageal varices. The purpose of this study was to evaluate the sensitivity of CT scans in detecting esophageal and gastric varices when compared to the gold standard of EGD. Methods After institutional board review was obtained, patients with esophageal varices, gastric varices, or both seen on CT abdomen and pelvis, CT chest, CT chest and abdomen pelvis, or EGD were included. Exclusion criteria comprised cases where EGD and CT scans were not performed at a UFJ location, if esophageal or gastric varices were not reported, and if CT scans were performed after an EGD. Results Compared to EGD-verified varices, CT scans demonstrated a sensitivity of approximately 38.3%, with scans performed within 7 days of each other improving sensitivity to 39.51% and 40.1% in contrasted studies. CT scans correctly detected varices in 45.90% of thrombocytopenic patients. Conclusion CT scans may play a role in interval screening between recommended EGD surveillance, especially in thrombocytopenic patients; however, our retrospective review demonstrates that their sensitivity for variceal detection is not sufficient to recommend them over EGD surveillance. More studies are needed to assess both the sensitivity and specificity of EGDs and CT scans in detecting gastroesophageal varices, particularly in the context of gastric varices. Trial Registration Retrospectively registered