Quantitative ultrasound for steatosis assessment using Hepatoscope®: Confounding technical factors

Abstract

Quantitative ultrasound (QUS) is a well-suited modality to address large-scale screening and monitoring of liver steatosis as it is low-cost, non-invasive, and point-of-care. However, technical and biological confounders lead to difficulties in establishing universal cutoff values for diagnosis. Hepatoscope® remedies this issue as it integrates a unique QUS measurement technique enabling the simultaneous measurements of the backscattering coefficient, the attenuation coefficient and the speed of sound. Such measurements are performed in a large two-dimensional region of interest (ROI) and in a free breathing regime such that a relatively large portion of the liver is sampled. We studied the influence of the size of the ROI, its depth and the number of measurements on the QUS parameters with Hepatoscope® both in vitro on four calibrated phantoms and clinically on 60 participants referred to a hepatology consultation for chronic liver disease. We demonstrated that using large ROIs consistently improves the system reliability and the clinical applicability. We did not observe any systematic effect related to the depth of the ROI. We also showed that averaging consecutive measurements leads to better system reliability and better clinical applicability.