Novel Quantitative Liver Steatosis Assessment Method With Ultrasound Harmonic Imaging

IF 2.1 4区医学 Q2 ACOUSTICS Journal of Ultrasound in Medicine Pub Date : 2024-09-24 DOI:10.1002/jum.16582

Ping Gong PhD, Jingke Zhang PhD, Chengwu Huang PhD, U-Wai Lok PhD, Shanshan Tang PhD, Hui Liu MD, PhD, Ryan DeRuiter PhD, Kendra Petersen, Kate Knoll, Kathryn Robinson, Kymberly Watt MD, Matthew Callstrom MD, PhD, Shigao Chen PhD

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Abstract

Objectives

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver disorder in Western countries, with approximately 20%–30% of the MASLD patients progressing to severe stages. There is an urgent need for noninvasive, cost-effective, widely accessible, and precise biomarkers to evaluate liver steatosis. This study aims to assess and compare the diagnostic performance of a novel reference frequency method-based ultrasound attenuation coefficient estimation (ACE) in both fundamental (RFM-ACE-FI) and harmonic (RFM-ACE-HI) imaging for detecting and grading liver steatosis.

Methods

An Institutional Review Board-approved prospective study was carried out between December 2018 and October 2022. A total number of 130 subjects were enrolled in the study. The correlation between RFM-ACE-HI values and magnetic resonance imaging proton density fat fraction (MRI-PDFF), as well as between RFM-ACE-FI values and MRI-PDFF were calculated. The diagnostic performance of RFM-ACE-FI and RFM-ACE-HI was evaluated using receiver operating characteristic (ROC) curve analysis, as compared to MRI-PDFF. The reproducibility of RFM-ACE-HI was assessed by interobserver agreement between two sonographers.

Results

A strong correlation was observed between RFM-ACE-HI and MRI-PDFF, with R = 0.88 (95% confidence interval [CI]: 0.83–0.92; P < .001), while the correlation between RFM-ACE-FI and MRI-PDFF was R = 0.65 (95% CI: 0.50–0.76; P < .001). The area under the ROC (AUROC) curve for RFM-ACE-HI in staging liver steatosis grades of S ≥ 1 and S ≥ 2 was 0.97 (95% CI: 0.91–0.99; P < .001) and 0.98 (95% CI: 0.93–1.00; P < .001), respectively, and 0.76 (95% CI: 0.65–0.85) and 0.80 (95% CI: 0.70–0.88) for RFM-ACE-FI, respectively. Great reproducibility was achieved for RFM-ACE-HI, with an interobserver agreement of R = 0.97 (95% CI: 0.94–0.99; P < .001).

Conclusions

The novel RFM-ACE-HI method offered high liver steatosis diagnostic accuracy and reproducibility, which has important clinical implications for early disease intervention and treatment evaluation.

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利用超声谐波成像的新型肝脏脂肪变性定量评估方法

研究目的代谢功能障碍相关性脂肪性肝病（MASLD）是西方国家最常见的肝脏疾病，约 20%-30% 的代谢功能障碍相关性脂肪性肝病患者会发展到严重阶段。评估肝脏脂肪变性迫切需要无创、经济、广泛使用且精确的生物标志物。本研究旨在评估和比较基于参考频率方法的新型超声衰减系数估算（ACE）在基波（RFM-ACE-FI）和谐波（RFM-ACE-HI）成像中检测和分级肝脏脂肪变性的诊断性能：2018年12月至2022年10月期间，开展了一项经机构审查委员会批准的前瞻性研究。共有 130 名受试者参与研究。计算了RFM-ACE-HI值与磁共振成像质子密度脂肪分数（MRI-PDFF）之间的相关性，以及RFM-ACE-FI值与MRI-PDFF之间的相关性。与 MRI-PDFF 相比，RFM-ACE-FI 和 RFM-ACE-HI 的诊断性能采用接收器操作特征（ROC）曲线分析法进行评估。RFM-ACE-HI 的可重复性通过两名超声技师的观察者间一致性进行评估：结果：RFM-ACE-HI 与 MRI-PDFF 之间具有很强的相关性，R = 0.88（95% 置信区间 [CI]：0.83-0.92；P=0.05）：R = 0.88（95% 置信区间 [CI]：0.83-0.92；P新型 RFM-ACE-HI 方法具有较高的肝脏脂肪变性诊断准确性和可重复性，对早期疾病干预和治疗评估具有重要的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound