Prospective comparative diagnostic performance of quantitative ultrasound parameters for the measurement of hepatic steatosis in a biopsy-proven metabolic dysfunction associated steatotic liver disease cohort

Abstract

Objectives The aim of this study was to compare the diagnostic performance of attenuation imaging (ATI), shear wave elastography (SWE) and shear wave dispersion (SWD) for detecting and grading hepatic steatosis in patients with metabolic dysfunctionassociated steatotic liver disease (MASLD). Methods 66 patients with MASLD (mean age, 41 years ± 12; 36 men, 30 women) confirmed histopathologically and 34 healthy volunteers (mean age, 39 years ± 15; 18 men, 16 women) who were age/sex-matched were prospectively enrolled in this study. ATI, SWE and SWD examinations were performed. Fibrosis stage, necroinflammatory activity and steatosis grade were confirmed histopathologically. Steatosis was graded as follows: S0 (<5%); S1 (5–32%); S2 (33–66%) to S3 (>66%). We compared the diagnostic performance of ATI, SWE and SWD for detecting and grading hepatic steatosis. Results Both attenuation coefficient (AC) and SWD values were significantly different among the different hepatic steatosis, and both were correlated with hepatic steatosis. SWE could not distinguish hepatic steatosis. ATI had better diagnostic performance than SWD for detecting and grading hepatic steatosis. The area under the receiver operating characteristic (ROC) curve of ATI for detecting ≥ S1, ≥ S2, and = S3 were 0.917 (cut-off value of 0.69 dB/cm/MHz), 0.933 (cut-off value of 0.74 dB/cm/MHz), and 0.870 (cut-off value of 0.82 dB/cm/MHz), respectively. The area under the ROC curve of SWD value was 0.758 (cut-off value of 10.79 m/s/kHz), 0.685 (cut-off value of 12.64 m/s/kHz), and 0.722 (cut-off value of 13.24 m/s/kHz), respectively. Conclusions ATI technology is a reliable method for detecting and grading hepatic steatosis in patients with MASLD than SWE and SWD. Advances in knowledge We compared the diagnostic performance of ATI, SWE, SWD for detecting and grading hepatic steatosis in patients with MASLD in order to find the best diagnostic parameters.