Non-invasive diagnosis of non-alcoholic fatty liver disease (NAFLD) using ultrasound image echogenicity

Benjamin, Alex; Zubajlo, Rebecca E.; Thomenius, Kai E.; Dhyani, Manish; Kaliannan, Kanakaraju; Samir, Anthony E.; Anthony, Brian W.

doi:10.1109/embc.2017.8037468

Cited by 12 publications

(8 citation statements)

References 22 publications

(25 reference statements)

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“…Liver biopsy is the current gold-standard for NAFLD diagnosis, but this invasive procedure has high degrees of variability and sampling error in addition to carrying associated risks and costs [5,6]. Liver biopsies have proved to be subjective with up to 50% of pathologist reads resulting in disagreement [7].…”

Section: Introductionmentioning

confidence: 99%

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Beyer¹,

Hutton²,

Andersson³

et al. 2021

PLoS ONE

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Background & aims MRI-based proton density fat fraction (PDFF) and the ultrasound-derived controlled attenuation parameter (CAP) are non-invasive techniques for quantifying liver fat, which can be used to assess steatosis in patients with non-alcoholic fatty liver disease (NAFLD). This study compared both of these techniques to histopathological graded steatosis for the assessment of fat levels in a large pooled NAFLD cohort. Methods This retrospective study pooled N = 581 participants from two suspected NAFLD cohorts (mean age (SD) 56 (12.7), 60% females). Steatosis was graded according to NASH-CRN criteria. Liver fat was measured non-invasively using PDFF (with Liver MultiScan’s Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation method, LMS-IDEAL, Perspectum, Oxford) and CAP (FibroScan, Echosens, France), and their diagnostic performances were compared. Results LMS-IDEAL and CAP detected steatosis grade ≥ 1 with AUROCs of 1.00 (95% CI, 0.99–1.0) and 0.95 (95% CI, 0.91–0.99), respectively. LMS-IDEAL was superior to CAP for detecting steatosis grade ≥ 2 with AUROCs of 0.77 (95% CI, 0.73–0.82] and 0.60 (95% CI, 0.55–0.65), respectively. Similarly, LMS-IDEAL outperformed CAP for detecting steatosis grade ≥ 3 with AUROCs of 0.81 (95% CI, 0.76–0.87) and 0.63 (95% CI, 0.56–0.70), respectively. Conclusion LMS-IDEAL was able to diagnose individuals accurately across the spectrum of histological steatosis grades. CAP performed well in identifying individuals with lower levels of fat (steatosis grade ≥1); however, its diagnostic performance was inferior to LMS-IDEAL for higher levels of fat (steatosis grades ≥2 and ≥3). Trial registration ClinicalTrials.gov (NCT03551522); https://clinicaltrials.gov/ct2/show/NCT03551522. UMIN Clinical Trials Registry (UMIN000026145); https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000026145.

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Section: Introductionmentioning

confidence: 99%

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Beyer¹,

Hutton²,

Andersson³

et al. 2021

PLoS ONE

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“…Crosstalk between the liver and the immune system has the potential for integrating the sensing of nutrients and pathogens 57 , and could begin to explain the effects of diet and gut microbiota on T1D development. Recent advances in non-invasive imaging methods such as magnetic resonance spectroscopy and ultrasound elastography may enable testing of this hypothesis in children at-risk of developing T1D 58,59 .…”

Section: Discussionmentioning

confidence: 99%

Dysregulated liver lipid metabolism and innate immunity associated with hepatic steatosis in neonatal BBdp rats and NOD mice

Serrano

Crookshank

Morgan

et al. 2019

Sci Rep

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In a previous study we reported that prediabetic rats have a unique gene signature that was apparent even in neonates. Several of the changes we observed, including enhanced expression of pro-inflammatory genes and dysregulated UPR and metabolism genes were first observed in the liver followed by the pancreas. In the present study we investigated further early changes in hepatic innate immunity and metabolism in two models of type 1 diabetes (T1D), the BBdp rat and NOD mouse. There was a striking increase in lipid deposits in liver, particularly in neonatal BBdp rats, with a less striking but significant increase in neonatal NOD mice in association with dysregulated expression of lipid metabolism genes. This was associated with a decreased number of extramedullary hematopoietic clusters as well as CD68+ macrophages in the liver of both models. In addition, PPARɣ and phosphorylated AMPKα protein were decreased in neonatal BBdp rats. BBdp rats displayed decreased expression of antimicrobial genes in neonates and decreased M2 genes at 30 days. This suggests hepatic steatosis could be a common early feature in development of T1D that impacts metabolic homeostasis and tolerogenic phenotype in the prediabetic liver.

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“…Researchers have also shown that longitudinal wave sound speed has similar diagnostic ability to shear wave imaging [11], [31], [32], [33], [34], [35]. Some of these results taken on breast tissue are presented in Table II (from [33]).…”

Section: Clinical Motivationmentioning

confidence: 92%

A Deep Learning Framework for Single-Sided Sound Speed Inversion in Medical Ultrasound

Feigin

Freedman

Anthony³

2020

IEEE Trans. Biomed. Eng.

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Objective: Ultrasound elastography is gaining traction as an accessible and useful diagnostic tool for such things as cancer detection and differentiation and thyroid disease diagnostics. Unfortunately, state of the art shear wave imaging techniques, essential to promote this goal, are limited to highend ultrasound hardware due to high power requirements; are extremely sensitive to patient and sonographer motion, and generally, suffer from low frame rates.Motivated by research and theory showing that longitudinal wave sound speed carries similar diagnostic abilities to shear wave imaging, we present an alternative approach using single sided pressure-wave sound speed measurements from channel data.Methods: In this paper, we present a single-sided sound speed inversion solution using a fully convolutional deep neural network. We use simulations for training, allowing the generation of limitless ground truth data.Results: We show that it is possible to invert for longitudinal sound speed in soft tissue at high frame rates. We validate the method on simulated data. We present highly encouraging results on limited real data.Conclusion: Sound speed inversion on channel data has significant potential, made possible in real time with deep learning technologies.Significance: Specialized shear wave ultrasound systems remain inaccessible in many locations. longitudinal sound speed and deep learning technologies enable an alternative approach to diagnosis based on tissue elasticity. High frame rates are possible.Index Terms-deep learning, inverse problems, ultrasound, sound speed inversion

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Non-invasive diagnosis of non-alcoholic fatty liver disease (NAFLD) using ultrasound image echogenicity

Cited by 12 publications

References 22 publications

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Dysregulated liver lipid metabolism and innate immunity associated with hepatic steatosis in neonatal BBdp rats and NOD mice

A Deep Learning Framework for Single-Sided Sound Speed Inversion in Medical Ultrasound

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