Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

Zhang, Bo; Ding, Fang; Chen, Tian; Xia, Lianghua; Qian, Juan; Liu, Guoyi

doi:10.3748/wjg.v20.i47.17985

Cited by 35 publications

(40 citation statements)

References 29 publications

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“…Lupsor et al [17], at a -0.114 cut-off value of AC for 0.842 AUROC, predicted severe HS (> 33%) on a cohort of 189 patients with viral chronic C hepatitis assesed by liver biopsy, with 84.2% Se and 78.53% Sp. A recent study [22] using a quantitative ultrasound model based on a combination of AC and hepatorenal attenuation index (SHRI) has predicted moderate HS with 81.4% Se and 100% Sp, but the assesment of fat load was performed by MRI spectroscopy as the gold standard. It is known that the accuracy of MRI spectroscopy to assess HS is lower than histopathological evaluation; in addition it does not allow HS classification by severity grade.…”

Section: Resultsmentioning

confidence: 99%

“…Even though the HRI sensitivity and specificity for the detection of moderate severe HS reported by various recent studies [18][19][20][21][22] are better (84-90% Se, 85-93% Sp) compared to our results obtained by using CVL and HSAI parameters (76.6 to 81.3% Se, 80.9 to 89% Sp), we have to mention that these studies were conducted on smaller number of patients (88-175 pts) and not all of these studies used the histopathologic examination as validation method. For these reasons we believe that our findings could have even a better value as the above mentioned studies.…”

Section: Discussionmentioning

confidence: 99%

“…Significant correlation between steatosis (evaluated by liver biopsy and MRI spectroscopy) and SHRI has been found in several studies. The sensitivity and specificity of SHRI varied in different studies between 81.4-92.7% and 54-93%, respectively [18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Computerized ultrasound image analysis for noninvasive evaluation of hepatic steatosis

et al. 2015

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Objective: To assess the diagnostic value of a particular set of local intensity parameters extracted from ultrasound liver images in conjunction with support vector machine (SVM) classifiers for liver steatosis grading in respect to the "gold standard" provided by liver biopsy. Material and methods: We prospectively enrolled in the study 228 patients with chronic hepatopathies. All the patients underwent liver biopsy and abdominal ultrasound examination. For quantitative ultrasound assessment of liver steatosis, an image analysis software was developed, which extracts three local intensity parameters from regions of interest (ROI) in the ultrasound section and analyzes their depth variation: the coefficient of variation of luminance (CVL), the median luminance (m l ), and the hepato-splenic attenuation index (HSAI). For steatosis grading, SVM classifiers were trained on the input feature spaces provided by the above mentioned parameters. The statistical significance of the steatosis grading was assessed on a significant test set using SVM classifiers, in terms of sensibility, specificity and through the ROC curves. Results: A cut-off value of 0.362 of the CVL of the liver performed the liver steatosis grading with an accuracy of 89.17% (p<0.0001). A cut-off value of 0.27 of the HSAI performed the prediction of the moderate-severe liver steatosis with an accuracy of 87%. Conclusions: The proposed computer analysis method of ultrasound images proved innovative and useful for the initial non-invasive assessment and grading of liver steatosis, with an additional advantage of reduced computational complexity and accessibility. The CVL provided a very good accuracy (89.17%) for an AUROC of 0.923 for the classification of liver steatosis in two severity categories (mild versus moderate-severe).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Computerized ultrasound image analysis for noninvasive evaluation of hepatic steatosis

et al. 2015

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“…Combining standard ultrasonography with computer software technology (MATLAB) (eg, combined ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate evaluation)18 improves the sensitivity of ultrasonography. Compared with proton-magnetic resonance spectroscopy (ie, the gold standard for detecting low levels of liver fat content), at levels of <15% liver fat content, the sensitivity and specificity of the ultrasound quantitative model was 81.4% and 100%.…”

Section: What Are the Next Investigations?mentioning

confidence: 99%

Tests for diagnosing and monitoring non-alcoholic fatty liver disease in adults

Byrne

Patel

Scorletti

et al. 2018

BMJ

117

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At a routine health check arranged by his company, a 52 year-old sedentary male computer programmer was found to have a serum alanine aminotransferase (ALT) concentration of 68 IU/L (normal 0-40 IU/L), and a triglyceride concentration of 1.9 mmol/L. His fasting plasma glucose levels were 5.8 mmol/L and other basic liver, renal and lipid blood tests were normal. He had an unremarkable medical history and took no regular medications, did not smoke and consumed <7 units of alcohol/week. Clinical examination was unremarkable. His body mass index was 29 kg/m 2 ; waist circumference 102 cm and blood pressure 134/88 mmHg.

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“…Az új, kvantitatív ultrahangmódszer (quantitative ultrasound model: liver fat content (%) = 61.519 × ultrasound hepatic/renal ratio + 167.701 × hepatic echo-intensity attenuation rate -26.736) egyszerű, olcsó, érzékeny a májelzsírosodás vizsgálatára, a kezelés haté-konyságának megítélésére a klinikai gyakorlatban [52].…”

Section: Táblázatunclassified

Non-invasive assessment of fatty liver

2015

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A májat érő különböző károsító hatások miatt (fertőző ágensek, anyagcserezavarok, nem megfelelő táplálkozás, elhí-zás, toxikus ártalmak, autoimmun folyamatok) kóros májműködés, májkárosodás jön létre, amely a máj elzsírosodá-sához, illetve kötőszövetes átépüléséhez vezethet. A májműködés zavarainak leggyakoribb okai a hepatitis B-és Cvírusok, az alkoholfogyasztás, illetve a nem alkoholos zsírmájbetegség. Napjainkban a májbetegségek kórisméjének arany standardja a szövettani vizsgálat. A májbiopszia veszélyei és szövődményei miatt azonban világszerte nagy az igény olyan, nem invazív jelzőmolekulák, pontrendszerek kidolgozására, képalkotó eljárások fejlesztésére, amelyek az elzsírosodás mértékét, illetve későbbiekben a betegség lefolyását, a gyulladásos aktivitást és a fi brosis fokát is jól jelzik. A szerzők összefoglaló közleményükben áttekintik a májelzsírosodás nem invazív jellemzésének lehetőségeit. Bemutatják a próbák mutatóit (pozitív, negatív prediktív érték, érzékenység, fajlagosság). Kitérnek a képalkotó eljárások klinikai alkalmazásaira is. Az ismertetett módszerek közül több hasznos, nem invazív eljárás a steatosis értékelésében, a betegség lefolyásának és a terápiás válasz nyomon követésében, de pontos megítélésükre további vizsgálatok szük-ségesek. Orv. Hetil., 2015, 156(14), 543-551. Kulcsszavak: májelzsírosodás, steatosis hepatis, nem invazív próbák, képalkotó eljárások Non-invasive assessment of fatty liverAs the result of various harmful effects (infectious agents, metabolic diseases, unhealthy diet, obesity, toxic agents, autoimmune processes) hepatic damage may develop, which can progress towards liver steatosis, and fi brosis as well. The most common etiological factors of liver damages are hepatitis B and C infection, alcohol consumption and nonalcoholic fatty liver disease. Liver biopsy is considered as the gold standard for the diagnosis of chronic liver diseases. Due to the dangers and complications of liver biopsy, studies are focused on non-invasive markers and radiological imaging for liver steatosis, progression of fatty liver, activity of the necroinfl ammation and the severity of the fi brosis. Authors review the possibilities of non-invasive assessment of liver steatosis. The statistical features of the probes (positive, negative predictive values, sensitivity, specifi city) are reviewed. The role of radiological imaging is also discussed. Although the non-invasive methods discussed in this article are useful to assess liver steatosis, further studies are needed to validate to follow progression of the diseases and to control therapeutic response. Keywords: liver steatosis, fatty liver, non-invasive methods, radiological imagingEgresi, A., Lengyel, G., Hagymási, K. [Non-invasive assessment of fatty liver]. Orv. Hetil., 2015, 156(14), 543-551. ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítések AFLD = alkoholos zsírmájbetegség; AGA = American Gastroenterological Association; ALP = alkalikus foszfatáz; ALT = alanin-aminotranszferáz; AST = aszpartát-aminotranszferáz; ATP = adenozin-trifoszfát; BMI = t...

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Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

Cited by 35 publications

References 29 publications

Computerized ultrasound image analysis for noninvasive evaluation of hepatic steatosis

Computerized ultrasound image analysis for noninvasive evaluation of hepatic steatosis

Tests for diagnosing and monitoring non-alcoholic fatty liver disease in adults

Non-invasive assessment of fatty liver

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