Rationale and Objectives
Non-alcoholic fatty liver disease (NAFLD) is currently diagnosed by liver biopsy or
MRI proton density fat fraction (MRI-PDFF) from left hepatic lobe (LTHL) and/or right
hepatic lobe (RTHL). The objective of this study was to compare the diagnostic value
of ultrasound attenuation coefficients (ACs) from RTHL and LTHL in detecting hepatic
steatosis using biopsy or MRI-PDFF as a reference standard.
Materials and Methods
Sixty-six patients with suspected NAFLD were imaged with an Aplio i800 ultrasound
scanner (Canon Medical Systems, Tustin, CA). Five AC measurements from RTHL and LTHL
were averaged separately and together to be compared with the reference standard.
Results
Forty-seven patients (71%) were diagnosed with NAFLD. Mean ACs were significantly
higher in fatty livers than non-fatty livers (RTHL: 0.73 ± 0.10 vs. 0.63 ± 0.07 dB/cm/MHZ;
p < 0.0001, LTHL: 0.78 ± 0.11 vs. 0.63 ± 0.06 dB/cm/MHz; p < 0.0001, RTHL & LTHL: 0.76 ± 0.09 vs. 0.63 ± 0.05 dB/cm/MHz; p < 0.0001). Biopsy steatosis grades (n =31) were better correlated with the mean ACs of RTHL & LTHL (r = 0.72) compared to LTHL (r = 0.67) or RTHL (r = 0.61). Correlation between MRI-PDFF (n = 35) and mean ACs was better for LTHL (r = 0.69) compared to the RTHL & LTHL (r = 0.66) or RTHL (r = 0.45). Higher diagnostic accuracy was shown for the mean ACs of RTHL & LTHL (AUC
0.89, specificity 94%, sensitivity 78%) compared to LTHL (AUC 0.89, specificity 88%,
sensitivity 82%) or RTHL (AUC 0.81, specificity 89%, sensitivity 68%).
Conclusion
Ultrasound ACs from RTHL and LTHL showed comparable diagnostic values in detection
of hepatic steatosis with the highest diagnostic accuracy when they were averaged
together.
Key Words
Abbreviation:
AC (attenuation coefficient), ATI (attenuation imaging), AUC (area under the curve), BMI (body mass index), LTHL (left hepatic lobe), MRI-PDFF (MRI-proton density fat fraction), NAFLD (non-alcoholic fatty liver disease), ROC (receiver operating characteristic), ROI (region of interest, RTHL, right hepatic lobe), std (standard deviation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 29, 2022
Accepted:
December 16,
2022
Received in revised form:
November 21,
2022
Received:
August 2,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
