A Pilot Comparative Study of Quantitative Ultrasound, Conventional Ultrasound, and MRI for Predicting Histology-Determined Steatosis Grade in Adult Nonalcoholic Fatty Liver Disease

A Pilot Comparative Study of Quantitative Ultrasound, Conventional Ultrasound, and MRI for Predicting Histology-Determined Steatosis Grade in Adult Nonalcoholic Fatty Liver Disease

The purpose of this study is to explore the diagnostic performance of two investigational quantitative ultrasound (QUS) parameters, attenuation coefficient and backscatter coefficient, in comparison with conventional ultrasound (CUS) and MRI-estimated proton density fat fraction (PDFF) for predictin...

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Bibliographic Details
Published in:American journal of roentgenology (1976) Vol. 208; no. 5; pp. W168 - W177
Main Authors: Paige, Jeremy S, Bernstein, Gregory S, Heba, Elhamy, Costa, Eduardo A C, Fereirra, Marilia, Wolfson, Tanya, Gamst, Anthony C, Valasek, Mark A, Lin, Grace Y, Han, Aiguo, Erdman, Jr, John W, O'Brien, Jr, William D, Andre, Michael P, Loomba, Rohit, Sirlin, Claude B
Format: Journal Article
Language:English
Published: United States 01-05-2017
Subjects:
Adult
Aged
Biopsy
Cross-Sectional Studies
Female
Humans
Magnetic Resonance Imaging - methods
Male
Middle Aged
Non-alcoholic Fatty Liver Disease - diagnostic imaging
Non-alcoholic Fatty Liver Disease - pathology
Phantoms, Imaging
Pilot Projects
Predictive Value of Tests
Prospective Studies
Ultrasonography - methods
nonalcoholic steatohepatitis
quantitative ultrasound
nonalcoholic fatty liver disease
attenuation
quantitative imaging biomarkers
interobserver agreement
backscatter
proton density fat fraction
grading accuracy
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Summary:The purpose of this study is to explore the diagnostic performance of two investigational quantitative ultrasound (QUS) parameters, attenuation coefficient and backscatter coefficient, in comparison with conventional ultrasound (CUS) and MRI-estimated proton density fat fraction (PDFF) for predicting histology-confirmed steatosis grade in adults with nonalcoholic fatty liver disease (NAFLD). In this prospectively designed pilot study, 61 adults with histology-confirmed NAFLD were enrolled from September 2012 to February 2014. Subjects underwent QUS, CUS, and MRI examinations within 100 days of clinical-care liver biopsy. QUS parameters (attenuation coefficient and backscatter coefficient) were estimated using a reference phantom technique by two analysts independently. Three-point ordinal CUS scores intended to predict steatosis grade (1, 2, or 3) were generated independently by two radiologists on the basis of QUS features. PDFF was estimated using an advanced chemical shift-based MRI technique. Using histologic examination as the reference standard, ROC analysis was performed. Optimal attenuation coefficient, backscatter coefficient, and PDFF cutoff thresholds were identified, and the accuracy of attenuation coefficient, backscatter coefficient, PDFF, and CUS to predict steatosis grade was determined. Interobserver agreement for attenuation coefficient, backscatter coefficient, and CUS was analyzed. CUS had 51.7% grading accuracy. The raw and cross-validated steatosis grading accuracies were 61.7% and 55.0%, respectively, for attenuation coefficient, 68.3% and 68.3% for backscatter coefficient, and 76.7% and 71.3% for MRI-estimated PDFF. Interobserver agreements were 53.3% for CUS (κ = 0.61), 90.0% for attenuation coefficient (κ = 0.87), and 71.7% for backscatter coefficient (κ = 0.82) (p < 0.0001 for all). Preliminary observations suggest that QUS parameters may be more accurate and provide higher interobserver agreement than CUS for predicting hepatic steatosis grade in patients with NAFLD.
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ISSN:0361-803X
1546-3141
DOI:10.2214/ajr.16.16726