Improved Ultrasound Attenuation Measurement Method for the Non-invasive Evaluation of Hepatic Steatosis Using FibroScan

• Published in: Ultrasound in medicine & biology Vol. 47; no. 11; pp. 3181 - 3195
• Main Authors: Audière, Stéphane, Labourdette, Aymeric, Miette, Véronique, Fournier, Céline, Ternifi, Redouane, Boussida, Salem, Pouletaut, Philippe, Charleux, Fabrice, Bensamoun, Sabine F., Harrison, Stephen A., Sandrin, Laurent
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.11.2021; Elsevier
• Subjects: Computer Science; Controlled attenuation parameter (CAP); Elasticity Imaging Techniques; Elastography; Engineering Sciences; FibroScan; Human health and pathology; Humans; Hépatology and Gastroenterology; Life Sciences; Liver; Liver - diagnostic imaging; Medical Imaging; Non-alcoholic Fatty Liver Disease - diagnostic imaging; Proton density fat fraction (PDFF); ROC Curve; Signal and Image processing; Steatosis; Ultrasonography; Ultrasound attenuation; Vibration-controlled transient elastography (VCTE); Proton density fat fraction (PDFF); Ultrasound attenuation; Liver; Controlled attenuation parameter (CAP); FibroScan; Vibration-controlled transient elastography (VCTE); Elastography; Steatosis; Vibration-Controlled Transient Elastography (VCTE); Proton Density Fat Fraction (PDFF); Controlled Attenuation Parameter (CAP)
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2021.07.007

Controlled attenuation parameter (CAP) is a measurement of ultrasound attenuation used to assess liver steatosis non-invasively. However, the standard method has some limitations. This study assessed the performance of a new CAP method by ex vivo and in vivo assessments. The major difference with the new method is that it uses ultrasound data continuously acquired during the imaging phase of the FibroScan examination. Seven reference tissue-mimicking phantoms were used to test the performance. In vivo performance was assessed in two cohorts (in total 195 patients) of patients using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as a reference. The precision of CAP was improved by more than 50% on tissue-mimicking phantoms and 22%–41% in the in vivo cohort studies. The agreement between both methods was excellent, and the correlation between CAP and MRI-PDFF improved in both studies (0.71 to 0.74; 0.70 to 0.76). Using MRI-PDFF as a reference, the diagnostic performance of the new method was at least equal or superior (area under the receiver operating curve 0.889–0.900, 0.835–0.873). This study suggests that the new continuous CAP method can significantly improve the precision of CAP measurements ex vivo and in vivo.