IATT Liver Fat Quantification for Steatosis Grading by Referring to MRI Proton Density Fat Fraction: a Multicenter Study

Overview

Journal J Gastroenterol

Specialty Gastroenterology

Date 2024 Mar 30

PMID 38553657

Authors

Masashi Hirooka

Sadanobu Ogawa

Yohei Koizumi

Yuichi Yoshida

Tatsuya Goto

Satoshi Yasuda

Masahiro Yamahira

Tsutomu Tamai

Ryoko Kuromatsu

Toshihisa Matsuzaki

Tomoyuki Suehiro

Yoshihiro Kamada

Yoshio Sumida

Yoichi Hiasa

Hidenori Toyoda

Takashi Kumada

Affiliations

Soon will be listed here.

Abstract

Background: Several preliminary reports have suggested the utility of ultrasound attenuation coefficient measurements based on B-mode ultrasound, such as iATT, for diagnosing steatotic liver disease. Nonetheless, evidence supporting such utility is lacking. This prospective study aimed to investigate whether iATT is highly concordant with magnetic resonance imaging (MRI)-based proton density fat fraction (MRI-PDFF) and could well distinguish between steatosis grades.

Methods: A cohort of 846 individuals underwent both iATT and MRI-PDFF assessments. Steatosis grade was defined as grade 0 with MRI-PDFF < 5.2%, grade 1 with 5.2% MRI-PDFF < 11.3%, grade 2 with 11.3% MRI-PDFF < 17.1%, and grade 3 with MRI-PDFF of 17.1%. The reproducibility of iATT and MRI-PDFF was evaluated using the Bland-Altman analysis and intraclass correlation coefficients, whereas the diagnostic performance of each steatosis grade was examined using receiver operating characteristic analysis.

Results: The Bland-Altman analysis indicated excellent reproducibility with minimal fixed bias between iATT and MRI-PDFF. The area under the curve for distinguishing steatosis grades 1, 2, and 3 were 0.887, 0.882, and 0.867, respectively. A skin-to-capsula distance of ≥ 25 mm was identified as the only significant factor causing the discrepancy. No interaction between MRI-logPDFF and MRE-LSM on iATT values was observed.

Conclusions: Compared to MRI-PDFF, iATT showed excellent diagnostic accuracy in grading steatosis. iATT could be used as a diagnostic tool instead of MRI in clinical practice and trials. Trial registration This study was registered in the UMIN Clinical Trials Registry (UMIN000047411).

Citing Articles

Assessing Quality of Ultrasound Attenuation Coefficient Results for Liver Fat Quantification.

Ferraioli G, Maiocchi L, Barr R, Roccarina D Diagnostics (Basel). 2024; 14(19).

PMID: 39410575 PMC: 11475129. DOI: 10.3390/diagnostics14192171.

References

Barr R, Wilson S, Rubens D, Garcia-Tsao G, Ferraioli G . Update to the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement. Radiology. 2020; 296(2):263-274. DOI: 10.1148/radiol.2020192437. View

Ogawa S, Kumada T, Gotoh T, Niwa F, Toyoda H, Tanaka J . A comparative study of hepatic steatosis using two different qualitative ultrasound techniques measured based on magnetic resonance imaging-derived proton density fat fraction. Hepatol Res. 2024; 54(7):638-654. DOI: 10.1111/hepr.14019. View

Petroff D, Blank V, Newsome P, Shalimar , Voican C, Thiele M . Assessment of hepatic steatosis by controlled attenuation parameter using the M and XL probes: an individual patient data meta-analysis. Lancet Gastroenterol Hepatol. 2021; 6(3):185-198. DOI: 10.1016/S2468-1253(20)30357-5. View

Qadri S, Vartiainen E, Lahelma M, Porthan K, Tang A, Idilman I . Marked difference in liver fat measured by histology magnetic resonance-proton density fat fraction: A meta-analysis. JHEP Rep. 2023; 6(1):100928. PMC: 10711480. DOI: 10.1016/j.jhepr.2023.100928. View

Angulo P, Kleiner D, Dam-Larsen S, Adams L, Bjornsson E, Charatcharoenwitthaya P . Liver Fibrosis, but No Other Histologic Features, Is Associated With Long-term Outcomes of Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology. 2015; 149(2):389-97.e10. PMC: 4516664. DOI: 10.1053/j.gastro.2015.04.043. View

Brandt A . Evaluation of new ultrasound techniques for clinical imaging in selected liver and vascular applications. Dan Med J. 2018; 65(3). View

Ferraioli G, Wong V, Castera L, Berzigotti A, Sporea I, Dietrich C . Liver Ultrasound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations. Ultrasound Med Biol. 2018; 44(12):2419-2440. DOI: 10.1016/j.ultrasmedbio.2018.07.008. View

Ferraioli G, Raimondi A, Maiocchi L, De Silvestri A, Filice C . Quantification of Liver Fat Content with the iATT Algorithm: Correlation with Controlled Attenuation Parameter. Diagnostics (Basel). 2022; 12(8). PMC: 9394249. DOI: 10.3390/diagnostics12081787. View

Vilar-Gomez E, Calzadilla-Bertot L, Wong V, Castellanos M, Aller-de la Fuente R, Metwally M . Fibrosis Severity as a Determinant of Cause-Specific Mortality in Patients With Advanced Nonalcoholic Fatty Liver Disease: A Multi-National Cohort Study. Gastroenterology. 2018; 155(2):443-457.e17. DOI: 10.1053/j.gastro.2018.04.034. View

10.

Hirooka M, Koizumi Y, Nakamura Y, Yano R, Hirooka K, Morita M . B-mode shear wave elastography can be an alternative method to vibration-controlled transient elastography according to a moderate-scale population study. J Med Ultrason (2001). 2023; 50(4):473-483. DOI: 10.1007/s10396-023-01333-8. View

11.

Imajo K, Toyoda H, Yasuda S, Suzuki Y, Sugimoto K, Kuroda H . Utility of Ultrasound-Guided Attenuation Parameter for Grading Steatosis With Reference to MRI-PDFF in a Large Cohort. Clin Gastroenterol Hepatol. 2021; 20(11):2533-2541.e7. DOI: 10.1016/j.cgh.2021.11.003. View

12.

Abu-Arafeh A, Jordan H, Drummond G . Reporting of method comparison studies: a review of advice, an assessment of current practice, and specific suggestions for future reports. Br J Anaesth. 2016; 117(5):569-575. DOI: 10.1093/bja/aew320. View

13.

Ferraioli G, Kumar V, Ozturk A, Nam K, de Korte C, Barr R . US Attenuation for Liver Fat Quantification: An AIUM-RSNA QIBA Pulse-Echo Quantitative Ultrasound Initiative. Radiology. 2022; 302(3):495-506. DOI: 10.1148/radiol.210736. View

14.

Ajmera V, Park C, Caussy C, Singh S, Hernandez C, Bettencourt R . Magnetic Resonance Imaging Proton Density Fat Fraction Associates With Progression of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology. 2018; 155(2):307-310.e2. PMC: 6090543. DOI: 10.1053/j.gastro.2018.04.014. View

15.

Tada T, Kumada T, Toyoda H, Kobayashi N, Sone Y, Oguri T . Utility of Attenuation Coefficient Measurement Using an Ultrasound-Guided Attenuation Parameter for Evaluation of Hepatic Steatosis: Comparison With MRI-Determined Proton Density Fat Fraction. AJR Am J Roentgenol. 2018; 212(2):332-341. DOI: 10.2214/AJR.18.20123. View

16.

Hagstrom H, Nasr P, Ekstedt M, Hammar U, Stal P, Hultcrantz R . Fibrosis stage but not NASH predicts mortality and time to development of severe liver disease in biopsy-proven NAFLD. J Hepatol. 2017; 67(6):1265-1273. DOI: 10.1016/j.jhep.2017.07.027. View

17.

Younossi Z, Golabi P, Paik J, Henry A, Van Dongen C, Henry L . The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023; 77(4):1335-1347. PMC: 10026948. DOI: 10.1097/HEP.0000000000000004. View

18.

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. 2018; 38(4):e48. DOI: 10.1055/a-0641-0076. View

19.

Tamaki N, Munaganuru N, Jung J, Yonan A, Loomba R, Bettencourt R . Clinical utility of 30% relative decline in MRI-PDFF in predicting fibrosis regression in non-alcoholic fatty liver disease. Gut. 2021; 71(5):983-990. PMC: 8594562. DOI: 10.1136/gutjnl-2021-324264. View

20.

Dulai P, Singh S, Patel J, Soni M, Prokop L, Younossi Z . Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta-analysis. Hepatology. 2017; 65(5):1557-1565. PMC: 5397356. DOI: 10.1002/hep.29085. View