WFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat Quantification

Giovanna Ferraioli¹, Richard Gary Barr², Annalisa Berzigotti³, Ioan Sporea⁴, Vincent Wai-Sun Wong⁵, Thomas Reiberger⁶, Thomas Karlas⁷, Maja Thiele⁸, Ana Carolina Cardoso⁹, Oyekoya Taiwo Ayonrinde¹⁰, Laurent Castera¹¹, Christoph Frank Dietrich¹², Hiroko Iijima¹³, Dong Ho Lee¹⁴, William Kemp¹⁵, Claudia P Oliveira¹⁶, Shiv Kumar Sarin¹⁷

Affiliations

¹ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. Electronic address: giovanna.ferraioli@unipv.it.
² Department of Radiology, Northeastern Ohio Medical University, Youngstown, OH, USA.
³ Department for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁴ Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.
⁵ Department of Medicine and Therapeutics, Medical Data Analytics Centre, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁶ Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Christian-Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, Vienna, Austria.
⁷ Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany.
⁸ Center for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; Department for Clinical Research, University of Southern Denmark, Odense, Denmark.
⁹ Hepatology Division, School of Medicine, Federal University of Rio de Janeiro, Clementino, Fraga Filho Hospital, Rio de Janeiro, RJ, Brazil.
¹⁰ Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA, Australia; Medical School, The University of Western Australia, Crawley, WA, Australia; Curtin Medical School, Curtin University, Bentley, WA, Australia.
¹¹ Université Paris-Cité, Inserm UMR1149, Centre de Recherche sur l'Inflammation, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, Clichy, France.
¹² Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem and Permancence, Bern, Switzerland.
¹³ Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Disease, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Ultrasound Imaging Center, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
¹⁴ Department of Radiology, College of Medicine, Seoul National University Hospital, Seoul National University, Seoul, Republic of Korea.
¹⁵ Department of Gastroenterology, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia.
¹⁶ Gastroenterology Department, Laboratório de Investigação (LIM07), Hospital das Clínicas de São Paulo, HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
¹⁷ Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

PMID: 38658207
DOI: 10.1016/j.ultrasmedbio.2024.03.014

Free article

Practice Guideline

WFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat Quantification

Giovanna Ferraioli et al. Ultrasound Med Biol. 2024 Aug.

Free article

. 2024 Aug;50(8):1088-1098.

doi: 10.1016/j.ultrasmedbio.2024.03.014. Epub 2024 Apr 23.

Authors

Affiliations

¹ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. Electronic address: giovanna.ferraioli@unipv.it.
² Department of Radiology, Northeastern Ohio Medical University, Youngstown, OH, USA.
³ Department for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁴ Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.
⁵ Department of Medicine and Therapeutics, Medical Data Analytics Centre, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁶ Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Christian-Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, Vienna, Austria.
⁷ Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany.
⁸ Center for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; Department for Clinical Research, University of Southern Denmark, Odense, Denmark.
⁹ Hepatology Division, School of Medicine, Federal University of Rio de Janeiro, Clementino, Fraga Filho Hospital, Rio de Janeiro, RJ, Brazil.
¹⁰ Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA, Australia; Medical School, The University of Western Australia, Crawley, WA, Australia; Curtin Medical School, Curtin University, Bentley, WA, Australia.
¹¹ Université Paris-Cité, Inserm UMR1149, Centre de Recherche sur l'Inflammation, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, Clichy, France.
¹² Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem and Permancence, Bern, Switzerland.
¹³ Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Disease, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Ultrasound Imaging Center, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
¹⁴ Department of Radiology, College of Medicine, Seoul National University Hospital, Seoul National University, Seoul, Republic of Korea.
¹⁵ Department of Gastroenterology, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia.
¹⁶ Gastroenterology Department, Laboratório de Investigação (LIM07), Hospital das Clínicas de São Paulo, HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
¹⁷ Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

PMID: 38658207
DOI: 10.1016/j.ultrasmedbio.2024.03.014

Abstract

The World Federation for Ultrasound in Medicine and Biology (WFUMB) has promoted the development of this document on multiparametric ultrasound. Part 2 is a guidance on the use of the available tools for the quantification of liver fat content with ultrasound. These are attenuation coefficient, backscatter coefficient, and speed of sound. All of them use the raw data of the ultrasound beam to estimate liver fat content. This guidance has the aim of helping the reader in understanding how they work and interpret the results. Confounding factors are discussed and a standardized protocol for measurement acquisition is suggested to mitigate them. The recommendations were based on published studies and experts' opinion but were not formally graded because the body of evidence remained low at the time of drafting this document.

Keywords: Attenuation coefficient; Attenuation imaging; Controlled attenuation parameter; Fatty liver; Liver steatosis; MAFLD; MASH; MASLD; NAFLD; NASH.

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Conflict of interest statement

Conflict of interest G.F. has received a speaker honorarium from Canon Medical Systems, Fujifilm Healthcare, Mindray Medical Imaging, Philips Ultrasound, Siemens Healthineers. She has served on advisory boards for Philips Healthcare and Siemens Healthineers and her university has received ultrasound equipment grants and unrestricted research grants from Canon Medical Systems, Esaote SpA, Fujifilm Medical Systems, Philips Ultrasound. She receives royalties from Elsevier Publisher. R.G.B. has received a speaker honorarium from Canon Medical systems, Philips Ultrasound, Siemens Healthineers, Mindray, Samsung Ultrasound, Hologic Ultrasound. He has received research grants from Philips Ultrasound, Canon Ultrasound, Canon MRI, Samsung, Siemens Healthineers, Hologic, Mindray and equipment grants from Canon Medical Systems, Philips Ultrasound, Mindray, Samsung Ultrasound and Siemens Healthineers. He is on the advisory board of Lantheus Medical. He receives royalties from Thieme Publishers and Elsevier Publisher. A.B. is consultant for Boehringer-Ingelheim and has received speaker honoraria from GE Healthcare and Hologic Ultrasound. She has received research ultrasound equipment support from GE Healthcare. I.S. has received speaker fees from Siemens Healthineers, General Electric, Samsung Ultrasound, Canon Medical Systems. V.W.W. served as a consultant or advisory board member for AbbVie, Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept, Inventiva, Novo Nordisk, Pfizer, Sagimet Biosciences, TARGET PharmaSolutions, and Visirna; and a speaker for Abbott, AbbVie, Gilead Sciences, Novo Nordisk, Unilab. He has received a research grant from Gilead Sciences and is a co-founder of Illuminatio Medical Technology. T.R. received grant support from Abbvie, Boehringer Ingelheim, Gilead, Intercept/Advanz Pharma, MSD, Myr Pharmaceuticals, Philips Healthcare, Pliant, Siemens and W. L. Gore & Associates; speaking honoraria from Abbvie, Gilead, Intercept/Advanz Pharma, Roche, MSD, W. L. Gore & Associates; consulting/advisory board fee from Abbvie, Astra Zeneca, Bayer, Boehringer Ingelheim, Gilead, Intercept/Advanz Pharma, MSD, Resolution Therapeutics, Siemens; and travel support from Abbvie, Boehringer Ingelheim, Dr. Falk Pharma, Gilead and Roche. T.K. has received speaker honoraria from Echosens, Falk Foundation and Jazz Pharmaceuticals. He has served on advisory boards for Echosens and his university has received ultrasound equipment and unrestricted research grants from Canon Medical Systems and Echosens. M.T. has received a speaker honorarium from Siemens Healthcare, Echosens, Norgine, Madrigal, Takeda, and Tillotts Pharma. Advisory fee from Boehringer Ingelheim, AstraZeneca, GSK. Co-founder and board member of Evido. Board member for Alcohol & Society (non-governmental organisation). A.C.C. has received speaker honorarium from Novo Nordisk. O.T.A. has served as a consultant or adviser to Novo Nordisk, Resonance Health, Norgine and Sun Pharma. He has received research ultrasound equipment support from Canon Medical Systems. L.C. has served as a consultant for Boston Pharmaceuticals, Echosens, GSK, Madrigal, MSD, Novo Nordisk, Pfizer, Sagimet and Siemens Healthineers; and lecture fees from Echosens, Gilead, Inventiva, Madrigal and Novo Nordisk. C.F.D. has received speaker honorarium from AbbVie, Bracco, Falk Foundation, Fujifilm Healthcare, GE Healthcare, Janssen, Mindray Medical Imaging, Olympus, Pentax, Siemens Healthcare, Sonoscape. H.I. has received research grants from Canon Medical Systems and GE Healthcare. She has received research ultrasound equipment support from Canon Medical Systems. D.H.L. has received research grants and speaker honorarium from Canon Medical Systems. W.K. has received speaker honorarium from Novo Nordisk, Eaisi, Roche. C.P.O. has been a consultant or participant in clinical trials for NovoNordisk, Pfizer, Inventiva, Astra-Zeneca, Boehringer Ingelheim. S.K.S. declares no conflict of interest.

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WFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat Quantification

Affiliations

WFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat Quantification

Authors

Affiliations

Abstract

Conflict of interest statement

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