Enhancing Liver Steatosis Classification: H-Scan Analysis of Handheld Ultrasound Data

Handheld ultrasound (H-US) offers a widely accessible and cost-effective option for future medicine. Quantitative US methods, such as H-Scan, could broaden its impact by leveraging the enormous potential of radiofrequency (RF) ultrasound data. H-US derived steatosis and fibrosis assessments would reduce the need for expensive FibroScan® devices, especially supporting low-resource areas. By filtering for lower (GH2) and higher (GH8) frequencies, the method allows for differentiation of scatter sizes related to varying degrees of steatosis, which is crucial for early detection of metabolic-associated steatotic liver disease (MASLD). Considering a substantial and various patient cohort of 468 patients, reducing potential selection bias inherent in smaller study cohorts, this study aims to investigate whether H-Scan analysis of RF-data captured with inexpensive H-US yields comparable results to those seen in previous studies. A strong correlation (r=0.852, p<0.0001)> $\alpha $ . No significant correlation was observed between H-Scan and the degree of liver fibrosis, suggesting that the current H-Scan alone might not be suitable for this application. Further research is needed to test and refine the methodology, especially regarding individual attenuation correction.