Abstract
A computer aided ultrasound (CAUS) protocol was developed for the diagnosis and staging of hepatic steatosis. Calibration of the fixed imaging preset enables expression of the US parameters relative to the tissue mimicking phantom used and consequently a vendor independent comparison. The CAUS protocol was validated on high yielding dairy cows (n = 151), which severed as a reference model for human non-alcoholic fatty liver disease. The study showed high values for: area under the curve (AROC): 0.94; sensitivity: 87%; specificity: 83%. A pilot study in patients on Home Parenteral Nutrition (HPN, n = 14) and a more extensive study in an obese cohort (n = 116) was performed. Validation was performed by Magnetic Resonance Spectroscopy (MRS). Both studies showed that of all parameters, the residual attenuation coefficient (RAC, the depth dependent mean echo level corrected for beam profile and normal attenuation in liver tissue) has the highest correlation to the reference (MRS fat percentage). For the HPN cohort, a correlation of 0.91 was found. In the obese population, this value was only 0.64; however, an AROC of 0.86, a sensitivity of 75%, and a specificity of 84% were obtained. In conclusion, CAUS shows promising results for non-invasive quantification of liver steatosis.
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