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. 2025 May 9.
doi: 10.1007/s00330-025-11652-8. Online ahead of print.

Ultrasound-derived fat fraction for diagnosing hepatic steatosis: a systematic review and meta-analysis

Sarah Verdan  1 , Giovanni B Torri  2 , Vinícius Neves Marcos  3 , Maria Helena Silva Moreira  3 , Maria Luiza R Defante  4 , Marília da Cruz Fagundes  5 , Emanuela Mendes Junqueira de Barros  6 , Adriano B Dias  7 , Luyao Shen  8 , Stephan Altmayer  8
Affiliations

Ultrasound-derived fat fraction for diagnosing hepatic steatosis: a systematic review and meta-analysis

Sarah Verdan et al. Eur Radiol. .

Abstract

Objective: To perform a systematic review and meta-analysis to evaluate the diagnostic performance of Ultrasound-Derived Fat Fraction (UDFF) in detecting hepatic steatosis using Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF) as the reference standard.

Materials and methods: Relevant databases were searched through November 2024. Studies that evaluated the UDFF to detect hepatic steatosis using MRI-PDFF as the reference standard met the inclusion criteria. Our primary outcome was the sensitivity and specificity of UDFF compared to MRI-PDFF in distinguishing steatosis from non-steatosis. Analyses were performed using a bivariate random-effects approach, and heterogeneity was considered substantial if I2 > 50%. A sensitivity analysis was performed to detect potential studies that contribute to heterogeneity.

Results: Nine studies comprising 1150 patients (mean age range, 14-62 years; 51.2% women) were included. Eight studies were performed using the same vendor platform. The pooled sensitivity of UDFF for detecting hepatic steatosis was 90.4% (95% CI: 84.0%, 94.4%), and the pooled specificity was 83.8% (95% CI: 75.1%, 89.8%). The AUC for the summary receiver-operating characteristic curve was 0.93 (95% CI: 0.83, 0.95). Heterogeneity among the studies was low (I² = 22.2%).

Conclusion: UDFF demonstrates high sensitivity and specificity for detecting hepatic steatosis, supporting its value as a noninvasive tool for screening.

Key points: Question Small individual studies suggest that US-Derived Fat Fraction (UDFF) may effectively detect hepatic steatosis compared to MRI, but no meta-analysis has been performed. Findings In nine studies including 1150 patients, UDFF demonstrated high pooled sensitivity (90.4%) and specificity (83.8%) relative to MRI with low between-study heterogeneity. Clinical relevance UDFF demonstrates high diagnostic accuracy compared with MRI, supporting its use as a noninvasive tool with potentially lower cost and wider availability for large-scale screening of hepatic steatosis.

Keywords: Hepatic steatosis; MASLD; Magnetic resonance imaging; Nonalcoholic fatty liver disease (NAFLD); Ultrasonography.

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Conflict of interest statement

Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Dr. Sarah Verdan. Conflict of interest: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: One of the authors, Dr. Stephan Altmayer, has significant statistical expertise. Informed consent: Written informed consent was not required for this study because it is a systematic review and meta-analysis of previously published data. Ethical approval: Institutional Review Board approval was not required because this study is a systematic review and meta-analysis of previously published data. All included studies had already obtained ethical approval from their respective institutional review boards, as stated in their original publications. Study subjects or cohorts overlap: Some study subjects or cohorts have been previously reported in the original studies included in this systematic review and meta-analysis. Any potential overlap was carefully assessed to ensure that duplicate data did not bias the results. Methodology: Systematic review and meta-analysis

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References

    1. Rinella ME, Lazarus JV, Ratziu V et al (2023) A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology 78:1966–1986. https://doi.org/10.1097/HEP.0000000000000520 - DOI - PubMed
    1. Chalasani N, Younossi Z, Lavine JE et al (2018) The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology 67:328–357. https://doi.org/10.1002/hep.29367 - DOI - PubMed
    1. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS et al (2023) AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 77:1797–1835. https://doi.org/10.1097/HEP.0000000000000323 - DOI - PubMed
    1. Le MH, Le DM, Baez TC et al (2023) Global incidence of non-alcoholic fatty liver disease: a systematic review and meta-analysis of 63 studies and 1,201,807 persons. J Hepatol 79:287–295. https://doi.org/10.1016/j.jhep.2023.03.040 - DOI - PubMed
    1. Tang A, Desai A, Hamilton G et al (2015) Accuracy of MR imaging–estimated proton density fat fraction for classification of dichotomized histologic steatosis grades in nonalcoholic fatty liver disease. Radiology 274:416–425. https://doi.org/10.1148/radiol.14140754 - DOI - PubMed

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