Hepatorenal Index by B‐Mode Ratio Versus Imaging and Fatty Liver Index to Diagnose Steatosis in Alcohol‐Related and Nonalcoholic Fatty Liver Disease
Objectives We aimed to evaluate the accuracy of the hepatorenal index by B‐mode ratio to diagnose hepatic steatosis, compared to ultrasound steatosis score, controlled attenuation parameter, and the fatty liver index using histology as the gold standard. Methods We prospectively included participant...
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Published in | Journal of ultrasound in medicine Vol. 42; no. 2; pp. 487 - 496 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Hoboken, USA
John Wiley & Sons, Inc
01.02.2023
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Subjects | |
Online Access | Get full text |
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Summary: | Objectives
We aimed to evaluate the accuracy of the hepatorenal index by B‐mode ratio to diagnose hepatic steatosis, compared to ultrasound steatosis score, controlled attenuation parameter, and the fatty liver index using histology as the gold standard.
Methods
We prospectively included participants with alcohol‐related or nonalcoholic fatty liver disease for same‐day noninvasive investigations and liver biopsy.
Results
We included 137 participants, 72% male, median age 60 years (53–65) and body mass index 32 kg/m2 (28–38). Eighty percent had steatosis (S0/S1/S2/S3 = 20/37/24/19%). B‐mode ratio had moderate diagnostic accuracy for any steatosis (≥S1, area under the receiver operating characteristics curve [AUROC] = 0.79; 95% confidence interval 0.70–0.88), significant steatosis (≥S2, AUROC = 0.76; 0.66–0.85), and severe steatosis (=S3, AUROC = 0.74; 0.62–0.86), independent of disease etiology. The cutoff values to rule‐out and rule‐in any steatosis were 1.09 and 1.45. While B‐mode ratio and controlled attenuation parameter correlated poorly, their diagnostic accuracies were comparable to each other and to ultrasound steatosis scoring. Fatty liver index did not differ from B‐mode ratio in detecting any steatosis but had poor accuracy to detect higher steatosis grades. B‐mode ratio measurements failed in 12% of patients, compared to 1% for ultrasound steatosis scoring and 2% for controlled attenuation parameter.
Conclusion
The hepatorenal index by B‐mode ratio diagnose steatosis with moderate accuracy in patients with alcohol‐related or nonalcoholic fatty liver disease, comparable to B‐mode ultrasound steatosis scoring and controlled attenuation parameter. However, its clinical use is limited by a high failure rate. |
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Bibliography: | This work has been presented with a poster by M.K. at the AASLD The Liver Meeting in 2020. We would like to acknowledge Louise Skovborg Just and Vibeke Nielsen for project management, Peter Andersen for logistic and practical support as well as data management, Ditlev Nytoft Rasmussen for statistical assistance, and the nurses at FLASH liver research center for assistance with liver biopsies and data collection. We would also like to acknowledge Odense Patient Data Explorative Network for data management. M.T. received a speaker's fee from Echosens, Siemens Healthcare, Norgine, and an advisory fee from GE Healthcare. A.K. reports advisory board and lecture fees from Norgine and Siemens. M.K. received a speaker's fee from Siemens Healthcare. This project received funding to the GALAXY project from the European Union's Horizon 2020 research and innovation program under grant number 668031, to the MicrobLiver project from the Novo Nordic Foundation Challenge program under grant number NNF15OC0016692, and from the Research Foundations for University of Southern Denmark, and Region of Southern Denmark. The Toyota Foundation and the AP Moeller Foundation granted funds to purchase the FibroScan and Aixplorer systems. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0278-4297 1550-9613 |
DOI: | 10.1002/jum.15991 |