Laura De Rosa, Antonio Salvati, Nicola Martini, Dante Chiappino, Simone Cappelli, Marcello Mancini, Libertario Demi, Lorenzo Ghiadoni, Ferruccio Bonino, Maurizia R. Brunetto, Francesco Faita
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Sonographic FLC assessment is qualitative and operator-dependent, and the dynamic quantification range of algorithms based on a single ultrasound (US) parameter is unsatisfactory.</p>\n \n <p>This study aims to develop and validate a new multiparametric algorithm based on B-mode images to quantify FLC using Magnetic Resonance (MR) values as standard reference.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Patients with elevated liver enzymes and/or bright liver at US (<i>N</i> = 195) underwent FLC evaluation by MR and by US. Five US-derived quantitative features [attenuation rate(AR), hepatic renal-ratio(HR), diaphragm visualization(DV), hepatic-portal-vein-ratio(HPV), portal-vein-wall(PVW)] were combined by mixed linear/exponential regression in a multiparametric model (Steatoscore2.0). One hundred and thirty-four subjects were used for training and 61 for independent validations; score-computation underwent an inter-operator reproducibility analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The model is based on a mixed linear/exponential combination of 3 US parameters (AR, HR, DV), modelled by 2 equations according to AR values. The computation of FLC by Steatoscore2.0 (mean ± std, 7.91% ± 8.69) and MR (mean ± std, 8.10% ± 10.31) is highly correlated with a low root mean square error in both training/validation cohorts, respectively (<i>R</i> = 0.92/0.86 and RMSE = 5.15/4.62, <i>p</i> < .001). Steatoscore2.0 identified patients with MR-FLC≥5%/≥10% with sensitivity = 93.2%/89.4%, specificity = 86.1%/95.8%, AUROC = 0.958/0.975, respectively and correlated with MR (<i>R</i> = 0.92) significantly (<i>p</i> < .001) better than CAP (<i>R</i> = 0.73).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Multiparametric Steatoscore2.0 measures FLC providing values highly comparable with MR. It is reliable, inexpensive, easy to use with any US equipment and qualifies to be tested in larger, prospective studies as new tool for the non-invasive screening and monitoring of FLC.</p>\n </section>\n </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"44 11","pages":"3008-3019"},"PeriodicalIF":6.0000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.16078","citationCount":"0","resultStr":"{\"title\":\"An ultrasound multiparametric method to quantify liver fat using magnetic resonance as standard reference\",\"authors\":\"Laura De Rosa, Antonio Salvati, Nicola Martini, Dante Chiappino, Simone Cappelli, Marcello Mancini, Libertario Demi, Lorenzo Ghiadoni, Ferruccio Bonino, Maurizia R. 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Five US-derived quantitative features [attenuation rate(AR), hepatic renal-ratio(HR), diaphragm visualization(DV), hepatic-portal-vein-ratio(HPV), portal-vein-wall(PVW)] were combined by mixed linear/exponential regression in a multiparametric model (Steatoscore2.0). One hundred and thirty-four subjects were used for training and 61 for independent validations; score-computation underwent an inter-operator reproducibility analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The model is based on a mixed linear/exponential combination of 3 US parameters (AR, HR, DV), modelled by 2 equations according to AR values. The computation of FLC by Steatoscore2.0 (mean ± std, 7.91% ± 8.69) and MR (mean ± std, 8.10% ± 10.31) is highly correlated with a low root mean square error in both training/validation cohorts, respectively (<i>R</i> = 0.92/0.86 and RMSE = 5.15/4.62, <i>p</i> < .001). 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引用次数: 0
摘要
背景和目的：临床实践中需要一种可靠、可重复的非侵入性脂肪肝含量（FLC）测量方法来监测脂肪肝。超声脂肪肝评估是定性的，且依赖于操作者，基于单一超声（US）参数的算法的动态量化范围并不令人满意。本研究旨在开发和验证一种新的多参数算法，该算法基于 B 型图像，以磁共振（MR）值为标准参考，对 FLC 进行量化：方法：肝酶升高和/或超声检查肝脏发亮的患者（N = 195）接受了磁共振和超声的FLC评估。在一个多参数模型（Steatoscore2.0）中，通过混合线性/指数回归将五个源自 US 的定量特征[衰减率（AR）、肝肾比（HR）、膈肌可视化（DV）、肝门静脉比（HPV）、门静脉壁（PVW）]结合起来。134名受试者被用于训练，61名受试者被用于独立验证；得分计算进行了操作者间可重复性分析：该模型基于 3 个 US 参数（AR、HR、DV）的混合线性/指数组合，根据 AR 值用 2 个方程建模。通过 Steatoscore2.0（平均值±标准差，7.91%±8.69）和 MR（平均值±标准差，8.10%±10.31）计算的 FLC 高度相关，且在两个训练/验证队列中的均方根误差都很低（R = 0.92/0.86 和 RMSE = 5.15/4.62，p 结论：Steatoscore2.0 和 MR 计算的 FLC 均具有较低的均方根误差：多参数 Steatoscore2.0 可测量 FLC，其值与 MR 非常接近。它可靠、便宜、易于使用任何 US 设备，有资格在更大规模的前瞻性研究中作为无创筛查和监测 FLC 的新工具进行测试。
An ultrasound multiparametric method to quantify liver fat using magnetic resonance as standard reference
Background & Aims
There is an unmet need for a reliable and reproducible non-invasive measure of fatty liver content (FLC) for monitoring steatotic liver disease in clinical practice. Sonographic FLC assessment is qualitative and operator-dependent, and the dynamic quantification range of algorithms based on a single ultrasound (US) parameter is unsatisfactory.
This study aims to develop and validate a new multiparametric algorithm based on B-mode images to quantify FLC using Magnetic Resonance (MR) values as standard reference.
Methods
Patients with elevated liver enzymes and/or bright liver at US (N = 195) underwent FLC evaluation by MR and by US. Five US-derived quantitative features [attenuation rate(AR), hepatic renal-ratio(HR), diaphragm visualization(DV), hepatic-portal-vein-ratio(HPV), portal-vein-wall(PVW)] were combined by mixed linear/exponential regression in a multiparametric model (Steatoscore2.0). One hundred and thirty-four subjects were used for training and 61 for independent validations; score-computation underwent an inter-operator reproducibility analysis.
Results
The model is based on a mixed linear/exponential combination of 3 US parameters (AR, HR, DV), modelled by 2 equations according to AR values. The computation of FLC by Steatoscore2.0 (mean ± std, 7.91% ± 8.69) and MR (mean ± std, 8.10% ± 10.31) is highly correlated with a low root mean square error in both training/validation cohorts, respectively (R = 0.92/0.86 and RMSE = 5.15/4.62, p < .001). Steatoscore2.0 identified patients with MR-FLC≥5%/≥10% with sensitivity = 93.2%/89.4%, specificity = 86.1%/95.8%, AUROC = 0.958/0.975, respectively and correlated with MR (R = 0.92) significantly (p < .001) better than CAP (R = 0.73).
Conclusions
Multiparametric Steatoscore2.0 measures FLC providing values highly comparable with MR. It is reliable, inexpensive, easy to use with any US equipment and qualifies to be tested in larger, prospective studies as new tool for the non-invasive screening and monitoring of FLC.
期刊介绍：
Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.
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