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. 2022 Jun 1;38(2):124-132.
doi: 10.1097/RUQ.0000000000000605.

Liver Ultrasound Attenuation: An Ultrasound Attenuation Index for Liver Steatosis Assessment

Ilias Gatos, Petros Drazinos  1 , Spyros Yarmenitis  1 , Ioannis Theotokas  1 , John Koskinas, Emmanouil Koullias, Asimina Mitranou, Emmanuel Manesis  2 , Pavlos S Zoumpoulis  1
Affiliations

Liver Ultrasound Attenuation: An Ultrasound Attenuation Index for Liver Steatosis Assessment

Ilias Gatos et al. Ultrasound Q. .

Abstract

Objectives: Nonalcoholic fatty liver disease (NAFLD) is the most widespread chronic liver disease type in the Western countries. Ultrasound (US) is used for NAFLD and hepatic steatosis (HS) grading. The most popular US method for NAFLD assessment is the hepatorenal index (HRI), but because of its limitations, other noninvasive methods have been developed. The Resona 7 US system has recently incorporated an US attenuation-related quantitative feature, liver ultrasound attenuation (LiSA), for HS estimation. The purpose of this study is to compare LiSA's and HRI's performance on NAFLD assessment.

Methods: A total of 159 NAFLD patients having a magnetic resonance imaging-proton density fat fraction (MRI-PDFF) examination were examined by 2 radiologists, who performed LiSA and HRI measurements in the liver. Correlation of LiSA's and HRI's measurements with MRI-PDFF values was calculated through Pearson correlation coefficient (PCC). To further investigate the performance of LiSA and HRI, optimum cutoffs, provided by the literature, were used to correspond HS grades to MRI-PDFF results. Moreover, a receiver operating characteristic (ROC) analysis on LiSA measurements and steatosis grades was performed.

Results: Magnetic resonance imaging-PDFF was better correlated with LiSA (PCC = 0.80) than HRI (PCC = 0.67). Receiver operating characteristic analysis showed better performance range for LiSA (77.8%-91.8%) than for HRI (72.8%-85.4%) on all HS grades for all studies used for corresponding MRI-PDFF values to HS grades.

Conclusions: The results indicate that LiSA is more accurate than HRI in HS differentiation and can lead to more accurate grading of HS on NAFLD patients.

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Conflict of interest statement

P.S.Z. has, during the last years, participated in webinars and live courses in cooperation with Mindray, for which he received honoraria. Diagnostic Echotomography has undertaken a clinical feedback project on behalf of the US equipment manufacturer company, Mindray. The project involved the loan of a Resona7 US system, from the Mindray part, and the sharing of clinical feedback, from the Diagnostic Echotomography part. For the remaining authors, no conflict of interest is declared.

References

    1. Younossi ZM, Stepanova M, Afendy M, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol . 2011;9:524–530.e1; quiz e60. doi:10.1016/j.cgh.2011.03.020. - DOI
    1. Adams LA, Sanderson S, Lindor KD, et al. The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies. J Hepatol . 2005;42:132–138. doi:10.1016/j.jhep.2004.09.012. - DOI
    1. Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology . 2006;43:S99–S112. doi:10.1002/hep.20973. - DOI
    1. Starley BQ, Calcagno CJ, Harrison SA. Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection. Hepatology . 2010;51:1820–1832. doi:10.1002/hep.23594. - DOI
    1. Younossi ZM. Non-alcoholic fatty liver disease—a global public health perspective. J Hepatol . 2019;70:531–544. doi:10.1016/J.JHEP.2018.10.033. - DOI

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