Diagnostic Efficiency on Ultrasound Shear Wave Elastography in Evaluation of Steatosis Severity for Non-alcoholic Fatty Liver Disease: a Rat Model

Overview

Journal Eur J Med Res

Publisher Biomed Central

Specialty General Medicine

Date 2023 Feb 11

PMID 36774529

Authors

Yuhui Wu

Qianjiao Liu

Yan Wang

Fangyan Li

Lawrence Wing-Chi Chan

Yong Wen

Fan Yang

Yining Xiang

Qinghong Duan

Peng Luo

Pinggui Lei

Affiliations

Soon will be listed here.

Abstract

Background: The pathological feature of steatosis affects the elasticity values measured by shear wave elastography (SWE) is still controversial in non-alcoholic fatty liver disease (NAFLD). The aim of this study is to demonstrate the influence of steatosis on liver stiffness measured by SWE on a rat model with NAFLD and analyze feasibility of SWE for grading steatosis in absence of fibrosis.

Methods: Sixty-six rats were fed with methionine choline deficient diet or standard diet to produce various stages of steatosis; 48 rats were available for final analysis. Rats underwent abdominal ultrasound SWE examination and pathological assessment. Liver histopathology was analyzed to assess the degree of steatosis, inflammation, ballooning, and fibrosis according to the non-alcoholic fatty liver disease activity score. The diagnostic performance of SWE for differentiating steatosis stages was estimated according to the receiver operating characteristic (ROC) curve. Decision curve analysis (DCA) was conducted to determine clinical usefulness and the areas under DCA (AUDCAs) calculated.

Results: In multivariate analysis, steatosis was an independent factor affecting the mean elastic modules (B = 1.558, P < 0.001), but not inflammation (B = - 0.031, P = 0.920) and ballooning (B = 0.216, P = 0.458). After adjusting for inflammation and ballooning, the AUROC of the mean elasticity for identifying S ≥ S1 was 0.956 (95%CI: 0.872-0.998) and the AUDCA, 0.621. The AUROC for distinguishing S ≥ S2 and S = S3 was 0.987 (95%CI: 0.951-1.000) and 0.920 (95%CI: 0.816-0.986) and the AUDCA was 0.506 and 0.256, respectively.

Conclusions: Steatosis is associated with liver stiffness and SWE may have the feasibility to be introduced as an assistive technology in grading steatosis for patients with NAFLD in absence of fibrosis.

Citing Articles

NO-IL-6/10-IL-1β axis: a new pathway in steatotic and non-steatotic liver grafts from brain-dead donor rats.

Casillas-Ramirez A, Mico-Carnero M, Sanchez-Gonzalez A, Maroto-Serrat C, Trostchansky A, Peralta C Front Immunol. 2023; 14:1178909.

PMID: 37593740 PMC: 10427871. DOI: 10.3389/fimmu.2023.1178909.

References

Huang Z, Zhou J, Lu X, Zhang T, Xu S, Jin J . How does liver steatosis affect diagnostic performance of 2D-SWE.SSI: assessment from aspects of steatosis degree and pathological types. Eur Radiol. 2020; 31(5):3207-3215. DOI: 10.1007/s00330-020-07288-5. View

Gatos I, Drazinos P, Yarmenitis S, Theotokas I, Koskinas J, Koullias E . Liver Ultrasound Attenuation: An Ultrasound Attenuation Index for Liver Steatosis Assessment. Ultrasound Q. 2022; 38(2):124-132. DOI: 10.1097/RUQ.0000000000000605. View

Dietrich C, Bamber J, Berzigotti A, Bota S, Cantisani V, Castera L . EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version). Ultraschall Med. 2017; 38(4):e16-e47. DOI: 10.1055/s-0043-103952. View

de Almeida E Borges V, Diniz A, Cotrim H, Rocha H, Andrade N . Sonographic hepatorenal ratio: a noninvasive method to diagnose nonalcoholic steatosis. J Clin Ultrasound. 2012; 41(1):18-25. DOI: 10.1002/jcu.21994. View

Takeuchi H, Sugimoto K, Oshiro H, Iwatsuka K, Kono S, Yoshimasu Y . Liver fibrosis: noninvasive assessment using supersonic shear imaging and FIB4 index in patients with non-alcoholic fatty liver disease. J Med Ultrason (2001). 2017; 45(2):243-249. DOI: 10.1007/s10396-017-0840-3. View

Garcovich M, Veraldi S, Di Stasio E, Zocco M, Monti L, Toma P . Liver Stiffness in Pediatric Patients with Fatty Liver Disease: Diagnostic Accuracy and Reproducibility of Shear-Wave Elastography. Radiology. 2016; 283(3):820-827. DOI: 10.1148/radiol.2016161002. View

Ong J, Younossi Z . Epidemiology and natural history of NAFLD and NASH. Clin Liver Dis. 2007; 11(1):1-16, vii. DOI: 10.1016/j.cld.2007.02.009. View

van Werven J, Marsman H, Nederveen A, Smits N, Ten Kate F, van Gulik T . Assessment of hepatic steatosis in patients undergoing liver resection: comparison of US, CT, T1-weighted dual-echo MR imaging, and point-resolved 1H MR spectroscopy. Radiology. 2010; 256(1):159-68. DOI: 10.1148/radiol.10091790. View

Dioguardi Burgio M, Imbault M, Ronot M, Faccinetto A, Van Beers B, Rautou P . Ultrasonic Adaptive Sound Speed Estimation for the Diagnosis and Quantification of Hepatic Steatosis: A Pilot Study. Ultraschall Med. 2018; 40(6):722-733. DOI: 10.1055/a-0660-9465. View

10.

Yoshioka Y, Hashimoto E, Yatsuji S, Kaneda H, Taniai M, Tokushige K . Nonalcoholic steatohepatitis: cirrhosis, hepatocellular carcinoma, and burnt-out NASH. J Gastroenterol. 2004; 39(12):1215-8. DOI: 10.1007/s00535-004-1475-x. View

11.

Shi K, Tang J, Zhu X, Ying L, Li D, Gao J . Controlled attenuation parameter for the detection of steatosis severity in chronic liver disease: a meta-analysis of diagnostic accuracy. J Gastroenterol Hepatol. 2014; 29(6):1149-58. DOI: 10.1111/jgh.12519. View

12.

Ogawa S, Moriyasu F, Yoshida K, Oshiro H, Kojima M, Sano T . Relationship between liver tissue stiffness and histopathological findings analyzed by shear wave elastography and compression testing in rats with non-alcoholic steatohepatitis. J Med Ultrason (2001). 2016; 43(3):355-60. DOI: 10.1007/s10396-016-0698-9. View

13.

Castera L, Friedrich-Rust M, Loomba R . Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology. 2019; 156(5):1264-1281.e4. PMC: 7505052. DOI: 10.1053/j.gastro.2018.12.036. View

14.

Gaia S, Carenzi S, Barilli A, Bugianesi E, Smedile A, Brunello F . Reliability of transient elastography for the detection of fibrosis in non-alcoholic fatty liver disease and chronic viral hepatitis. J Hepatol. 2010; 54(1):64-71. DOI: 10.1016/j.jhep.2010.06.022. View

15.

Yang J, Lin L, Xue E, Hong D, Yang Y, Xu M . Can Nonfibrotic Nonalcoholic Steatohepatitis Be Effectively Identified by Supersonic Shear Imaging?. Anal Cell Pathol (Amst). 2019; 2019:2013674. PMC: 6442442. DOI: 10.1155/2019/2013674. View

16.

Mendoza Y, Rodrigues S, Delgado M, Murgia G, Lange N, Schropp J . Inflammatory activity affects the accuracy of liver stiffness measurement by transient elastography but not by two-dimensional shear wave elastography in non-alcoholic fatty liver disease. Liver Int. 2021; 42(1):102-111. PMC: 9299715. DOI: 10.1111/liv.15116. View

17.

Nightingale K, Rouze N, Rosenzweig S, Wang M, Abdelmalek M, Guy C . Derivation and analysis of viscoelastic properties in human liver: impact of frequency on fibrosis and steatosis staging. IEEE Trans Ultrason Ferroelectr Freq Control. 2015; 62(1):165-75. PMC: 4405169. DOI: 10.1109/TUFFC.2014.006653. View

18.

Fujii H, Kawada N, Japan Study Group Of Nafld Jsg-Nafld . The Role of Insulin Resistance and Diabetes in Nonalcoholic Fatty Liver Disease. Int J Mol Sci. 2020; 21(11). PMC: 7312931. DOI: 10.3390/ijms21113863. View

19.

Lee M, Bae J, Joo S, Woo H, Lee D, Jung Y . Prospective comparison among transient elastography, supersonic shear imaging, and ARFI imaging for predicting fibrosis in nonalcoholic fatty liver disease. PLoS One. 2017; 12(11):e0188321. PMC: 5703509. DOI: 10.1371/journal.pone.0188321. View

20.

Vetelainen R, van Vliet A, van Gulik T . Essential pathogenic and metabolic differences in steatosis induced by choline or methione-choline deficient diets in a rat model. J Gastroenterol Hepatol. 2007; 22(9):1526-33. DOI: 10.1111/j.1440-1746.2006.04701.x. View