Acoustic structure quantification by using ultrasound Nakagami imaging for assessing liver fibrosis

Abstract

Acoustic structure quantification (ASQ) is a recently developed technique widely used for detecting liver fibrosis. Ultrasound Nakagami parametric imaging based on the Nakagami distribution has been widely used to model echo amplitude distribution for tissue characterization. We explored the feasibility of using ultrasound Nakagami imaging as a model-based ASQ technique for assessing liver fibrosis. Standard ultrasound examinations were performed on 19 healthy volunteers and 91 patients with chronic hepatitis B and C (n = 110). Liver biopsy and ultrasound Nakagami imaging analysis were conducted to compare the METAVIR score and Nakagami parameter. The diagnostic value of ultrasound Nakagami imaging was evaluated using receiver operating characteristic (ROC) curves. The Nakagami parameter obtained through ultrasound Nakagami imaging decreased with an increase in the METAVIR score (p < 0.0001), representing an increase in the extent of pre-Rayleigh statistics for echo amplitude distribution. The area under the ROC curve (AUROC) was 0.88 for the diagnosis of any degree of fibrosis (≥F1), whereas it was 0.84, 0.69, and 0.67 for ≥F2, ≥F3, and ≥F4, respectively. Ultrasound Nakagami imaging is a model-based ASQ technique that can be beneficial for the clinical diagnosis of early liver fibrosis.

Ultrasound Backscatter Envelope Statistics Parametric Imaging for Liver Fibrosis Characterization: A Review

“…Picrosirius red-stained sections (100 × magnification) obtained from patients' livers with different stages of fibrosis from F0 to F4: (a) F0, (b) F1, (c) F2, (d) F3, and (e) F4. 3 Reproduced from Tsui et al 3 in accordance with the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/). Copyright © Tsui et al 3…”

“…The above studies showed the feasibility of Nakagami imaging in assessing liver fibrosis, but the diagnostic performance (e.g., AUROC) was not investigated. In 2016, Tsui et al 3 reported that for 91 patients with chronic hepatitis B and C (biopsy: F0 = 4, F1 = 19, F2 = 23, F3 = 12, and F4 = 33), the AUROC for diagnosing fibrosis stages ≥F1, ≥F2, ≥F3, and ≥F4 with Nakagami imaging was 0.88, 0.84, 0.69, and 0.67 (p < 0.0001), respectively. Figures 10 and 11 show respectively B-mode ultrasound images and Nakagami images obtained from the healthy volunteers and patients with liver fibrosis (F0-F4).…”

“…Figure 2 presents the picrosirius red-stained sections (100 × magnification) obtained from patients' livers with different stages of fibrosis from F0 to F4. 3 However, liver biopsy is invasive and associated with sampling errors and can lead to complications such as bleeding. Therefore, developing noninvasive imaging techniques for assessing liver fibrosis is of clinical value.…”

“…In this paper, we focused on the development of ultrasound backscatter envelope statistics parametric imaging techniques for assessing liver fibrosis from 1998 to September 2019. 3, We classified these techniques into six categories: constant false alarm rate (CFAR), [26][27][28][29] fiber structure extraction technique (FSET), [30][31][32] acoustic structure quantification (ASQ), [33][34][35][36][37][38][39][40][41][42][43][44] quantile-quantile probability plot (Q-Q plot), [45][46][47][48][49] the multi-Rayleigh model, [50][51][52][53][54][55][56][57][58][59][60][61][62][63] and the Nakagami model. 3,[64][65][66][67][68][69][70] We summarized these techniques and their applications in liver fibrosis...…”

Monitoring of Adult Zebrafish Heart Regeneration Using High-Frequency Ultrasound Spectral Doppler and Nakagami Imaging

“…In addition, the performance of Nakagami imaging for tissue characterization is less affected by different scanner settings. Nakagami imaging has demonstrated its capability for characterizing tissue properties and has shown promising results in many applications, such as cancer diagnosis, staging of liver fibrosis, and thermal ablation monitoring [20,21,22,23,24,25,26,27]. Although the Nakagami imaging has been used for many applications, it has not yet been applied to a tissue regeneration study.…”