Effect of skin–capsular distance on controlled attenuation parameter for diagnosing liver steatosis in patients with nonalcoholic fatty liver disease

Abstract

The effect of the skin–capsular distance (SCD) on the controlled attenuation parameter (CAP) for diagnosis of liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD) remains unclear. The SCD was measured using B-mode ultrasound, and the CAP was measured using the M probe of FibroScan®. According to the indications of the M probe, 113 patients with an SCD of ≤ 25 mm were included in the present study. The association between the SCD and CAP was investigated, and the diagnostic performance of the SCD-adjusted CAP was tested. The SCD showed the most significant positive correlation with the CAP (ρ = 0.329, p < 0.001). In the multiple regression analysis, the SCD and serum albumin concentration were associated with the CAP, independent of pathological liver steatosis. According to the multivariate analysis, two different formulas were developed to obtain the adjusted CAP using the SCD and serum albumin concentration as follows: adjusted CAP (dB/m) = CAP − (5.26 × SCD) and adjusted CAP (dB/m) = CAP − (5.35 × SCD) − (25.77 × serum albumin concentration). The area under the receiver operating characteristic curve for diagnosis of a steatosis score ≥ 2 of adjusted CAP was 0.678 and 0.684 respectively, which were significantly greater than the original CAP (0.621: p = 0.030 and p = 0.024). The SCD is associated with the CAP independent of liver steatosis. Adjustment of the CAP using the SCD improves the diagnostic performance of the CAP in NAFLD.

Relationship between controlled attenuated parameter and magnetic resonance imaging–proton density fat fraction for evaluating hepatic steatosis in patients with NAFLD

“…This might be attributed to the measurement error of CAP in assessing changes in liver fat content before and after treatment. As is known, some factors, such as the spatial heterogeneity of liver steatosis, [ 19 ] hepatic inflammation, and skin–capsular distance, [ 20 ] might affect CAP measurement.…”

Effect modification of hepatitis B viral load on the association between metabolic risk factors and hepatic steatosis

“…Retrospective data collection is limited by the availability of information on the electronic medical records. CAP has been reported to have reduced diagnostic accuracy in patients with obesity ( 25 , 31 , 32 ). It may also be affected by variations in geographic regions, cutoffs, and age ( 25 ).…”

Diagnostic value of FibroTouch in identifying hepatic steatosis in NAFLD with MRI‐PDFF as the reference standard

“…The area under the receiver operating characteristic (ROC) curve (AUROC) and 95% confidence interval (CI) were 0.823 (0.809–0.837), 0.865 (0.850–0.880), and 0.882 (0.858–0.906) for identifying steatosis grades ≥S1, ≥S2, and ≥S3, respectively 12 . However, body mass index (BMI), diabetes mellitus, etiology, and skin–capsular distance (SCD) are found to significantly influence CAP 12,14–16 . Thanks to recent advancements in ultrasound technology, FibroTouch, which consists of a two‐dimensional ultrasound image‐guided system, a broadband dynamic probe, and a modified TE application with a SCD detection algorithm module, has been developed, which improves the success rate and accuracy of the examinations 17,18 .…”

“…12 However, body mass index (BMI), diabetes mellitus, etiology, and skin-capsular distance (SCD) are found to significantly influence CAP. 12,[14][15][16] Thanks to recent advancements in ultrasound technology, FibroTouch, which consists of a two-dimensional ultrasound image-guided system, a broadband dynamic probe, and a modified TE application with a SCD detection algorithm module, has been developed, which improves the success rate and accuracy of the examinations. 17,18 Several studies have shown a strong correlation between FibroTouch-based ultrasound attenuation parameter (UAP) and the grading of histologically proven steatosis.…”