A prospective evaluation of hepatic steatosis using quantitative ultrasonographic parameters using controlled attenuation parameter as the reference standard

Abstract

Purpose To investigate the diagnostic performance of quantitative ultrasonography (QUS) for the assessment of hepatic steatosis in patients with chronic liver disease using controlled attenuation parameter (CAP) as the reference standard. Materials and Methods Our institutional review board approved this study, and informed consent was obtained from all of the patients. In this prospective study, we analyzed 216 patients with chronic liver disease who had reliable measurement results at both QUS and CAP. QUS parameters included center frequency shift (a slope of center frequency change according to depth) and Nakagami parameter (backscattered distribution). Correlation between QUS parameters and CAP was evaluated using the Pearson's correlation analysis. In addition, based on the cut-off value of ≥ 288 dB/m on CAP, diagnostic performance of QUS parameters for hepatic steatosis was assessed using the receiver operating characteristics (ROC) curve analysis. Multiple regression analysis was performed to determine significant independent factors for the hepatic steatosis on CAP. Intra-operator reliability (repeatability) of QUS parameter measurements was assessed with intraclass correlation coefficients (ICCs). Results Center frequency shift showed a moderate negative correlation with CAP (r = −0.66; 95% confidence interval (CI), −0.73 to −0.59; P Conclusion Quantitative ultrasonographic parameters, including center frequency shift and Nakagami parameter, were demonstrated to be well correlated with CAP and thus may provide good diagnostic performance in the assessment of hepatic steatosis, making it a promising tool for the noninvasive assessment and quantification of hepatic steatosis.