Improved Method for Calculating Hepatic Steatosis Using the Hepatorenal Index

Abstract

The hepatorenal index can be quickly and accurately calculated from DICOM images directly on a PACS without supplementary software.

Reader agreement and accuracy of ultrasound features for hepatic steatosis

“…Our study used a standardized imaging protocol acquired by experienced sonographers and image interpretation by expert radiologists for published features of hepatic steatosis, thus it is unlikely that reader agreement could be further improved with increased expertise with image acquisition or interpretation. As such, if more reproducible measurements of hepatic steatosis are needed, less subjective measures such as the hepatorenal index that can be applied to conventional ultrasound images may be used [20,21]. Also, quantitative ultrasound-based approaches such as the controlled attenuation parameter measured as part of vibration-controlled transient elastography [22–25] or more recent quantitative measurements of ultrasound backscatter and attenuation coefficients [26,27] may also be used.…”

A Practical Approach to Quantitative Grayscale Ultrasound Analysis of Hepatic Steatosis in Pediatric Patients Using a Picture Archiving and Communication System–Based Tool

“…To overcome the variability of subjective US assessments, quantitative measurement of the grayscale echo intensity of tissues in multiple anatomic locations, including breast, thyroid, ascitic fluid, and liver, has been promoted by several investigators . Among these, the hepatorenal ratio has been used for quantification of liver parenchyma using kidneys as reference tissue . Most of these investigations of the liver grayscale echo intensity, however, have been performed with special software and computer systems, requiring cumbersome transfer of images and manual measurements.…”

“…Most of these investigations of the liver grayscale echo intensity, however, have been performed with special software and computer systems, requiring cumbersome transfer of images and manual measurements. To address this obstacle, Shiralkar et al developed a more practical alternative using a readily available picture archiving and communication system (PACS) to measure the grayscale US echo intensity. To our knowledge there are only a few studies, such as those by Lee et al and Shiralkar et al, that used a PACS tool for measurement of the liver grayscale echo intensity as an adjunct to subjective US imaging to help predict liver diseases.…”

“…To address this obstacle, Shiralkar et al developed a more practical alternative using a readily available picture archiving and communication system (PACS) to measure the grayscale US echo intensity. To our knowledge there are only a few studies, such as those by Lee et al and Shiralkar et al, that used a PACS tool for measurement of the liver grayscale echo intensity as an adjunct to subjective US imaging to help predict liver diseases. In particular, Shiralkar et al initiated the use of the hepatorenal ratio method using PACS.…”

“…To our knowledge there are only a few studies, such as those by Lee et al and Shiralkar et al, that used a PACS tool for measurement of the liver grayscale echo intensity as an adjunct to subjective US imaging to help predict liver diseases. In particular, Shiralkar et al initiated the use of the hepatorenal ratio method using PACS. Moreover, these PACS studies were performed in adults, with little data available in children .…”