Quantitative ultrasound (QUS) in the evaluation of liver steatosis: data reliability in different respiratory phases and body positions

Abstract

Liver steatosis is the most common chronic liver disease and affects 10–24% of the general population. As the grade of disease can range from fat infiltration to steatohepatitis and cirrhosis, an early diagnosis is needed to set the most appropriate therapy. Innovative noninvasive radiological techniques have been developed through MRI and US. MRI-PDFF is the reference standard, but it is not so widely diffused due to its cost. For this reason, ultrasound tools have been validated to study liver parenchyma. The qualitative assessment of the brightness of liver parenchyma has now been supported by quantitative values of attenuation and scattering to make the analysis objective and reproducible. We aim to demonstrate the reliability of quantitative ultrasound in assessing liver fat and to confirm the inter-operator reliability in different respiratory phases. We enrolled 45 patients examined during normal breathing at rest, peak inspiration, peak expiration, and semi-sitting position. The highest inter-operator agreement in both attenuation and scattering parameters was achieved at peak inspiration and peak expiration, followed by semi-sitting position. In conclusion, this technology also allows to monitor uncompliant patients, as it grants high reliability and reproducibility in different body position and respiratory phases.

Future Perspectives on Radiomics in Acute Liver Injury and Liver Trauma

“…Focused Assessment with Sonography in Trauma UltraSound (FAST-US) is the first-level exam for traumatized patients, and, whether associated with chest X-ray or pelvis X-ray, FAST-US has a sensitivity and specificity of 90% and 93%, respectively, to identify major injuries in patients who experienced trauma [ 9 , 10 , 11 ]. Although the latest evidence about FAST-US is comforting, the choice of avoiding Contrast-Enhanced Computed Tomography (CE-CT) as a screening exam in an emergency is still controversial [ 12 , 13 , 14 ].…”