Controlled attenuation parameter for the detection and quantification of hepatic steatosis in nonalcoholic fatty liver disease

Abstract

CAP is excellent for the detection of significant hepatic steatosis. However, its accuracy is impaired by an increased BMI, and it is less accurate to distinguish between the different grades of hepatic steatosis.

Diagnostic Accuracy of Controlled Attenuation Parameter Measured by Transient Elastography for the Non-invasive Assessment of Liver Steatosis: a Prospective Study

“…This study confirms, on a series of Romanian patients, the preliminary results of previous studies [20,[22][23][24][25][26][27][28][29][30][31], namely that, among all histopathological parameters assessed during various diffuse liver diseases, CAP is independently influenced only by the amount of steatosis, not by fibrosis, necroinflammatory activity, ballooning or lobular inflammation (quantified according to liver disease etiology). The CAP value increased alongside the increase in the steatosis degree.…”

“…Among histopathological parameters, these studies analyzed mainly the influence of steatosis and fibrosis on CAP and, in some studies, also that of necroinflammatory activity. To our knowledge, only one study, performed on NASH patients, included the influence of lobular inflammation and ballooning on CAP, apart from that of steatosis and fibrosis [31]. Until the present day, no study has yet analysed the concomitant influence of all histopathological parameters (steatosis, fibrosis, necroinflammatory activity, ballooning) which independently influence the CAP value and its performance in predicting each steatosis grade on biopsied patients with CLD from Romania.…”

Magnetic Resonance Elastography vs Transient Elastography in Detection of Fibrosis and Noninvasive Measurement of Steatosis in Patients with Biopsy-Proven Nonalcoholic Fatty Liver Disease

“…23-25, 28, 29 Our study is also consistent with prior studies showing TE to have high negative predictive value for diagnosing significant fibrosis (stages 2-4), severe fibrosis (stages 3-4), and cirrhosis, 14,15 and CAP to be accurate for diagnosing any steatosis, but not at higher dichotomized grades of steatosis. 17,18 A recent seminal study by Imajo et al 32 has shown that MRE is more accurate than TE for diagnosing significant fibrosis (stage 2-4 versus 0-1) and cirrhosis in Japanese NAFLD patients. In comparison, our study showed that MRE is more accurate than TE for diagnosing any fibrosis (stage 1-4 versus 0) but not cirrhosis (p = 0.0546) Although Imajo el al.…”

“…[13][14][15] Additionally, the controlled attenuation parameter (CAP) allows TE to simultaneously assess steatosis. [16][17][18] An important limitation of TE is the high failure rates in obese patients with BMI of > 28 kg/m 2 , 19,20 which limits reliable measurement of liver stiffness and steatosis in a significant portion of obese NAFLD patients. However, the new XL probe equipped with CAP has shown to reduce the failure rate for measuring fibrosis and steatosis in obese patients.…”

Importance of imaging and recent developments in diagnosis of nonalcoholic fatty liver disease

“…Controlled attenuation parameter (CAP) has been proposed as a noninvasive method for the determination and measurement of hepatic steatosis. The mechanism of CAP is the reduction in amplitude of ultrasound that can be estimated as it is amplified through the liver tissue using the same radio-frequency data used for estimation of liver stiffness using Fibroscan (Echosens, Paris, France), an ultrasound based vibration-controlled transient elastography device [59] . The shear stiffness of normal liver is between 6.5 and 7 kPa.…”