Ultrasonography.  2024 Jul;43(4):250-262. 10.14366/usg.24040.

Diagnostic performance of quantitative ultrasonography for hepatic steatosis in a health screening program: a prospective single-center study

• Pyo JH
• Cho SJ
• Choi SC
• Jee JH
• Yun J
• Hwang JA
• Park G
• Kim K
• Kang W
• Kang M
• Byun Yh

• KMID: 2556692
• DOI: http://doi.org/10.14366/usg.24040

Abstract

Purpose
This study compared the diagnostic performance of quantitative ultrasonography (QUS) with that of conventional ultrasonography (US) in assessing hepatic steatosis among individuals undergoing health screening using magnetic resonance imaging–derived proton density fat fraction (MRI-PDFF) as the reference standard.
Methods
This single-center prospective study enrolled 427 participants who underwent abdominal MRI and US. Measurements included the attenuation coefficient in tissue attenuation imaging (TAI) and the scatter-distribution coefficient in tissue scatter-distribution imaging (TSI). The correlation between QUS and MRI-PDFF was evaluated. The diagnostic capabilities of QUS, conventional B-mode US, and their combined models for detecting hepatic fat content of ≥5% (MRI-PDFF ≥5%) and ≥10% (MRI-PDFF ≥10%) were compared by analyzing the areas under the receiver operating characteristic curves. Additionally, clinical risk factors influencing the diagnostic performance of QUS were identified using multivariate linear regression analyses.
Results
TAI and TSI were strongly correlated with MRI-PDFF (r=0.759 and r=0.802, respectively; both P<0.001) and demonstrated good diagnostic performance in detecting and grading hepatic steatosis. The combination of QUS and B-mode US resulted in the highest areas under the ROC curve (AUCs) (0.947 and 0.975 for detecting hepatic fat content of ≥5% and ≥10%, respectively; both P<0.05), compared to TAI, TSI, or B-mode US alone (AUCs: 0.887, 0.910, 0.878 for ≥5% and 0.951, 0.922, 0.875 for ≥10%, respectively). The independent determinants of QUS included skinliver capsule distance (β=7.134), hepatic fibrosis (β=4.808), alanine aminotransferase (β=0.202), triglyceride levels (β=0.027), and diabetes mellitus (β=3.710).
Conclusion
QUS is a useful and effective screening tool for detecting and grading hepatic steatosis during health checkups.

Keyword

Fatty liver; Quantitative ultrasound; Tissue attenuation imaging; Tissue scatter distribution imaging; Magnetic resonance imaging–derived proton density fat fraction