Noninvasive Diagnosis of Nonalcoholic Fatty Liver Disease and Quantification of Liver Fat Using a New Quantitative Ultrasound Technique
Abstract
Background & Aims Liver biopsy analysis is the standard method used to diagnose nonalcoholic fatty liver disease (NAFLD). Advanced magnetic resonance imaging is a noninvasive procedure that can accurately diagnose and quantify steatosis, but is expensive. Conventional ultrasound is more accessible but identifies steatosis with low levels of sensitivity, specificity, and quantitative accuracy, and results vary among operators. A new quantitative ultrasound (QUS) technique can identify steatosis in animal models. We assessed the accuracy of QUS in the diagnosis and quantification hepatic steatosis, comparing findings with those from MRI proton density fat fraction (MRI-PDFF) analysis as a reference. Methods We performed a prospective, cross-sectional analysis of a cohort of adults (n=204) with NAFLD (MRI-PDFF≥5%) and without NAFLD (controls). Subjects underwent MRI-PDFF and QUS analyses of the liver on the same day at the University of California, San Diego, from February 2012 through March 2014. QUS parameters and backscatter coefficient (BSC) values were calculated. Patients were randomly assigned to training (n=102; mean age, 51±17 years; mean body mass index, 31±7 kg/m2) and validation (n=102; mean age, 49±17 years; body mass index, 30±6 kg/m2) groups; 69% of patients in each group had NAFLD. Results BSC (range 0.00005–0.25 1/cm-sr) correlated with MRI-PDFF (Spearman’s ρ=0.80; P<.0001). In the training group, the BSC analysis identified patients with NAFLD with an area…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 204 participants or records.
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