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Altered probe pressure and body position increase diagnostic accuracy for men and women in detecting hepatic steatosis using quantitative ultrasound
Umeå University, Faculty of Medicine, Department of Radiation Sciences. Department of Radiology in Östersund, Östersund, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.ORCID iD: 0000-0001-9338-1639
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Department of Radiology in Linköping, Linköping, Sweden.ORCID iD: 0000-0003-3124-8044
Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.ORCID iD: 0000-0002-2928-4188
Umeå University, Faculty of Medicine, Department of Radiation Sciences.ORCID iD: 0000-0003-4288-1208
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2024 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: To evaluate the diagnostic performance of ultrasound guided attenuation parameter (UGAP) for evaluating liver fat content with different probe forces and body positions, in relation to sex, and compared with proton density fat fraction (PDFF).

Methods: We prospectively enrolled a metabolic dysfunction-associated steatotic liver disease (MASLD) cohort that underwent UGAP and PDFF in the autumn of 2022. Mean UGAP values were obtained in supine and 30° left decubitus body position with normal 4 N and increased 30 N probe force. The diagnostic performance was evaluated by the area under the receiver operating characteristic curve (AUC).

Results: Among 60 individuals (mean age 52.9 years, SD 12.9; 30 men), we found the best diagnostic performance with increased probe force in 30° left decubitus position (AUC 0.90; 95% CI 0.82–0.98) with a cut-off of 0.58 dB/cm/MHz. For men, the best performance was in supine (AUC 0.91; 95% CI 0.81–1.00) with a cut-off of 0.60 dB/cm/MHz, and for women, 30° left decubitus position (AUC 0.93; 95% CI 0.83–1.00), with a cut-off 0.56 dB/cm/MHz, and increased 30 N probe force for both genders. No difference was in the mean UGAP value when altering body position. UGAP showed good to excellent intra-reproducibility (Intra-class correlation 0.872; 95% CI 0.794–0.921).

Conclusion: UGAP provides excellent diagnostic performance to detect liver fat content in metabolic dysfunction-associated steatotic liver diseases, with good to excellent intra-reproducibility. Regardless of sex, the highest diagnostic accuracy is achieved with increased probe force with men in supine and women in 30° left decubitus position, yielding different cut-offs.

Clinical relevance statement: The ultrasound method ultrasound-guided attenuation parameter shows excellent diagnostic accuracy and performs with good to excellent reproducibility. There is a possibility to alter body position and increase probe pressure, and different performances for men and women should be considered for the highest accuracy.

Place, publisher, year, edition, pages
Springer Nature, 2024.
National Category
Clinical Medicine
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URN: urn:nbn:se:umu:diva-222436DOI: 10.1007/s00330-024-10655-1ISI: 001177772800001PubMedID: 38459346Scopus ID: 2-s2.0-85187190134OAI: oai:DiVA.org:umu-222436DiVA, id: diva2:1845160
Funder
Medical Research Council of Southeast Sweden (FORSS), 752871Region Jämtland HärjedalenLinköpings universitetLions Cancerforskningsfond i Norr, 20-2221Available from: 2024-03-18 Created: 2024-03-18 Last updated: 2024-03-18

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Byenfeldt, MarieGrönlund, ChristerLindam, Anna

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