Multiparametric ultrasound evaluation of metabolic dysfunction-associated fatty liver disease in minipigs.

Objective: This study aimed to quantitatively assess hepatic steatosis using multiparametric 2-D ultrasound techniques in a choline-deficient high-fat diet minipig model, comparing the results with histological analysis at two time points.

Methods: Quantitative ultrasound (QUS) such as attenuation coefficient, backscatter ratio and speed of sound estimation, shear wave elastography and ultrasound localization microscopy, was performed on 17 minipigs. Histological analysis served as the ground truth.

Results: The results demonstrate that both the attenuation coefficient and backscatter ratio effectively detected hepatic steatosis, showing significantly higher values in steatotic compared with non-steatotic livers, consistent with findings in human and animal studies. However, speed of sound estimation measurements did not show any significant differences. shear wave elastography measurements were correlated with fibrosis at higher grades. Ultrasound localization microscopy, with its technical challenges, did not reveal significant hemodynamic changes or allow discrimination between steatosis groups.

Conclusion: Our study highlights the potential of multiparametric QUS for comprehensive liver assessment, although challenges remain, particularly in ultrasound localization microscopy techniques. Future research should focus on improving motion correction and developing automatic data-processing methods. The combination of QUS parameters could offer a more nuanced understanding of liver disease, paving the way for a non-invasive, multiparametric diagnostic approach akin to magnetic resonance imaging radiomics.