Liver and Spleen Point Shear-Wave Elastography in Newly Diagnosed BCR::ABL1-Negative Myeloproliferative Neoplasms: Associations with Hematological Parameters and Bone Marrow Fibrosis Grade - A Prospective Cross-Sectional Study.

OBJECTIVE

This study aimed to quantify liver and spleen stiffness at diagnosis in newly diagnosed, treatment-naive BCR::ABL1-negative myeloproliferative neoplasms (MPNs) using point shear-wave elastography (pSWE) and to explore associations with hematological parameters and bone marrow fibrosis grade.

MATERIALS AND

METHODS

Prospective pSWE was performed for 33 newly diagnosed, treatment-naive patients with BCR::ABL1-negative MPNs, including cases of essential thrombocythemia (n=13), primary myelofibrosis (MF) (n=12), and polycythemia vera (n=8), and for 31 age- and sex-matched controls. Shear-wave velocity (Vs, m/s) was recorded as the median of ≥10 valid measurements per organ, with interquartile range/median of <30% as the reliability criterion. Correlations with blood counts and bone marrow fibrosis grade were evaluated. Receiver operating characteristic curve analysis was exploratory because of the modest sample size and limited number of high-grade fibrosis cases.

RESULTS

Hepatic Vs was higher in patients than in the control group (1.21 [1.09-1.34] vs. 0.98 [0.86-1.11] m/s; p<0.01), whereas splenic Vs was similar between the groups (3.09 [2.76-3.50] vs. 3.21 [2.91-3.44] m/s; p=0.41). Hepatic Vs correlated with leukocyte count (r=0.47; p<0.01) and bone marrow fibrosis grade (r=0.47; p<0.05). Hepatic Vs identified MF of grade 3 with an area under the curve value of 0.77; however, the proposed cut-off of ≥1.22 m/s should be interpreted as a preliminary research threshold rather than a clinically validated threshold.

CONCLUSION

At diagnosis, hepatic stiffness was increased in this treatment-naive BCR::ABL1-negative MPN cohort and showed a modest association with marrow fibrosis grade and leukocyte count. Splenic stiffness was not increased in this mixed-subtype cohort. These findings support hepatic pSWE as a hypothesis-generating adjunct to baseline phenotyping but not as a replacement for bone marrow biopsy or hematological risk assessment.