DIAGNOSTIC ACCURACY OF CONTROLLED ATTENUATION PARAMETER FOR STEATOSIS ASSESSMENT IN CHRONIC LIVER DISEASES USING THE M AND THE XL PROBES

• Published in: Ultrasound in medicine & biology Vol. 48; p. S15
• Main Authors: Șerban, Teodora, Silion, Alexandra-Iulia, Lupsor-Platon, Monica
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 2022
• Subjects: chronic liver disease; Controlled Attenuation Parameter; Radiology; steatosis; Vibration Controlled Transient Elastography; chronic liver disease; Controlled Attenuation Parameter; steatosis; Vibration Controlled Transient Elastography
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2022.04.059

Hepatic steatosis is a frequent histological finding among subjects with chronic liver diseases (CLDs) (1). The present study analyzed the diagnostic accuracy (DA) of controlled attenuation parameter (CAP) in predicting each steatosis grade, using liver biopsy (LB) as the reference standard, in a large unicenter cohort. We prospectively included 669 consecutive CLD patients. All of them underwent CAP measurement using the M or the XL probe, one day before LB. The diagnostic performance of CAP was calculated using the area under the receiver operating characteristic curve (AUROC). At univariate analysis, several parameters seemed to influence CAP, including steatosis grade, steatosis type, ballooning, skin-to-liver capsule distance (SCD), BMI, and age. However, after multivariate analysis, only the steatosis grade and the SCD had a significant effect on the CAP value (p=0.000). The median (range) CAP (dB/m) values for each steatosis grade were: 217.5 (129-394) for S0, 293.5 (100-398) for S1, 269 (100-391) for S2, and 307 (178-400) for S3. CAP managed to differentiate with high statistical power between all degrees of steatosis (p=0.000), except S1 from S2(p>0.05). The optimum CAP cut-off values (dB/m) were 250.5 for ≥S1, 264.5 for ≥S2 and 287.5 for S3, with AUROC values of 0.732, 0.714 and 0.762, respectively. The maximum DA was obtained for the prediction of severe steatosis (77.73%). 76 cases (11,4%) had SR<60%, while 22 patients (3,3%) had no measurement obtained (SR=0) using the M probe. After multivariate analysis, SR<60% remained significantly influenced by SCD (p=0.003) and gender (p=0.026). The introduction of the novel XL probe overcame this downside among 20 subjects, being unaccountable in only 2 cases, both with alcoholic liver disease. CAP is significantly influenced by steatosis and the SCD. CAP detects HS with good accuracy among Romanian patients with various CLD.