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Diagnostic accuracy of ultrasound-guided attenuation parameter as a noninvasive test for steatosis in non-alcoholic fatty liver disease

  • Special Feature: Review Article
  • Quantitative assessment of liver steatosis using ultrasound
  • Published:
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Abstract

The purpose of this study was to evaluate the diagnostic accuracy of the ultrasound-guided attenuation parameter (UGAP) using the LOGEQ E10 for hepatic steatosis in non-alcoholic fatty liver disease (NAFLD) patients and directly compare UGAP with attenuation imaging (ATI) and controlled attenuation parameter (CAP). We prospectively analyzed 105 consecutive patients with NAFLD who underwent UGAP, ATI, CAP, and liver biopsy on the same day between October 2019 and April 2021. The diagnostic ability of the UGAP-determined attenuation coefficient (AC) was evaluated using receiver operating characteristic (ROC) curve analysis, and its correlation with ATI-determined AC values or CAP values was investigated. The success rate of UGAP was 100%. The median IQR/med obtained by UGAP was 4.0%, which was lower than that of ATI and CAP (P < 0.0001). The median ACs obtained by UGAP for grades S0 (control), S1, S2, and S3 were 0.590, 0.670, 0.750, and 0.845 dB/cm/MHz, respectively, demonstrating a stepwise increase with increasing hepatic steatosis severity (P < 0.0001). The areas under the ROC curve of UGAP for identifying ≥ S1, ≥ S2, and S3 were 0.890, 0.906, and 0.912, respectively, which were significantly better than the results obtained with CAP for identifying S3. Furthermore, the correlation coefficient between UGAP-AC and ATI-AC values was 0.803 (P < 0.0001), indicating a strong relationship. Our results indicate that UGAP has high diagnostic accuracy for detecting and grading hepatic steatosis in patients with NAFLD.

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Acknowledgements

The authors would like to thank Ms. Yuriko Mikami and Ms. Koko Motodate for their excellent technical assistance. This study was supported by JSPS KAKENHI [grant number JP 19K08400].

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Authors and Affiliations

  1. Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Nishitokuta 2-1-1, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan

    Hidekatsu Kuroda, Tamami Abe, Yudai Fujiwara, Tomoaki Nagasawa & Yasuhiro Takikawa

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  1. Hidekatsu Kuroda
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  2. Tamami Abe
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  3. Yudai Fujiwara
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  4. Tomoaki Nagasawa
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Correspondence to Hidekatsu Kuroda.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration, and was approved by the Ethics Review Board of Iwate Medical University (MH2019-131). Prior to the start of the study, written informed consent was obtained from all patients to use their laboratory data.

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Kuroda, H., Abe, T., Fujiwara, Y. et al. Diagnostic accuracy of ultrasound-guided attenuation parameter as a noninvasive test for steatosis in non-alcoholic fatty liver disease. J Med Ultrasonics 48, 471–480 (2021). https://doi.org/10.1007/s10396-021-01123-0

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  • DOI: https://doi.org/10.1007/s10396-021-01123-0

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