Ultrasound examination versus Controlled Attenuation Parameter for the detection and quantification of hepatic steatosis

Abstract

Introduction and aim Transient Elastography with Controlled Attenuation Parameter(CAP) was recently introduced as a noninvasive method for quantification of liver steatosis.The aim of this study is to assess the performance of ultrasound(US) compared to CAP for the detection and quantification of liver steatosis. Material and Methods 323 patients aged 22-83 (54.7 ± 13.5), 44% male (142/323), 56% female (181/323) with or without different chronic hepatopathies were included in the study.All patients were assessed by US and CAP using Transient Elastography (FibroScan, EchoSense) during the same session in fasting conditions.US examinations were performed by EFSUMB level 1 qualification practitioners using high tech US systems. We used the following cut-offs for quantifying liver steatosis by CAP: 230-275, 275-300 and > 300 db/m for mild, moderate and severe steatosis(S1,S2,S3) following the recommendations of the manufacturer.US classification of liver steatosis was based on the comparison between liver and renal cortex echogenicity; grade 0 – echogenicity equal to the renal cortex, grade 1 – increased echogenicity and no posterior attenuation, grade 2 - increased echogenicity and posterior attenuation without obscuring the diaphragmatic outline, grade 3 - echogenic liver with posterior attenuation that obscures the diaphragmatic outline. Results Based on the cut-off values proposed (CAP) steatosis distribution was 28.8% / 23.2% / 15.8% / 32.2% for S0 / S1 / S2 / S3.By means of US steatosis distribution was 31.6% / 23.5% / 20.4% / 24.5% for S0 / S1 / S2 / S3.Regarding hepatic steatosis US was significantly correlated with CAP score (r = 0.77, p Conclusion US examination is a useful and cheap tool for clinical practice in the screening and quantification of hepatic steatosis, even in the hands of a novice.