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Quantification of hepatic steatosis with ultrasound: promising role of attenuation imaging coefficient in a biopsy-proven cohort

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To prospectively assess the role of the US attenuation imaging coefficient (AC) for the diagnosis and quantification of hepatic steatosis.

Methods

One hundred and one patients underwent liver biopsy and US-AC measurement on the same day. Liver steatosis was graded according to biopsy as absent (S0 < 5%), mild (S1 5–33%), moderate (S2 33–66%), or severe (S3 > 66%); liver fibrosis was graded from F0 to F4. The correlation between AC and steatosis on pathology (%) was calculated using the Pearson correlation coefficient. The Student t or Mann–Whitney U test was used to compare continuous variables and ROC curve analysis was used to assess diagnostic performance of AC in diagnosing steatosis.

Results

Overall, 43 (42%), 35 (35%), 12 (12%), and 11 (11%) patients were classified as S0, S1, S2, and S3, respectively. The AC was positively correlated with steatosis as a continuous variable (%) on pathology (r = 0.58, p < 0.01). Patients with steatosis of any grade had a higher AC than those without steatosis (mean 0.77 ± 0.13 vs. 0.63 ± 0.09 dB/cm/MHz, respectively; p < 0.01, AUROC = 0.805). Patients with S2–S3 had a higher AC than patients with S0–1 (0.85 ± 0.11 vs. 0.67 ± 0.11 dB/cm/MHz, respectively; p < 0.01, AUROC = 0.892). AC > 0.69 dB/cm/MHz had a sensitivity and specificity of 76% and 86%, respectively, for diagnosing any grade of steatosis (S1–S3), and AC > 0.72 dB/cm/MHz had a sensitivity and specificity of 96% and 74%, respectively, for diagnosing S2–S3. The presence of advanced fibrosis (F3–F4) did not affect the calculated AC.

Conclusions

The attenuation imaging coefficient is a promising quantitative technique for the non-invasive diagnosis and quantification of hepatic steatosis.

Key Points

• Measurement of the attenuation coefficient is achieved with a very high rate of technical success.

• We found a significant positive correlation between the attenuation coefficient and the grade of steatosis on pathology.

• The attenuation imaging coefficient is a promising quantitative technique for the noninvasive diagnosis and quantification of hepatic steatosis.

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Abbreviations

AC:

Attenuation coefficient

ATI:

Attenuation imaging

CAP:

Controlled attenuation parameter

EASL:

European Association for the Study of the Liver

NAFLD:

Non-alcoholic fatty liver disease

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    Marco Dioguardi Burgio, Maxime Ronot, Edouard Reizine, Bernard Van Beers & Valérie Vilgrain

  2. INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France

    Marco Dioguardi Burgio, Maxime Ronot, Philippe Garteiser, Bernard Van Beers & Valérie Vilgrain

  3. University Paris Diderot, Sorbonne Paris Cité, Paris, France

    Maxime Ronot, Bernard Van Beers & Valérie Vilgrain

  4. Department of Hepatology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    Pierre-Emmanuel Rautou & Laurent Castera

  5. Department of Pathology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    Valérie Paradis

Authors
  1. Marco Dioguardi Burgio
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Correspondence to Marco Dioguardi Burgio.

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The scientific guarantor of this publication is Marco Dioguardi Burgio.

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 has significant statistical expertise.

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Dioguardi Burgio, M., Ronot, M., Reizine, E. et al. Quantification of hepatic steatosis with ultrasound: promising role of attenuation imaging coefficient in a biopsy-proven cohort. Eur Radiol 30, 2293–2301 (2020). https://doi.org/10.1007/s00330-019-06480-6

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  • DOI: https://doi.org/10.1007/s00330-019-06480-6

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