Ultrasound imaging in nonalcoholic liver disease: current applications and future developments

Yang, Kuen-Cheh; Liao, Yin-Yin; Tsui, Po-Hsiang; Yeh, Chih‐Kuang

doi:10.21037/qims.2019.03.14

Cited by 22 publications

(21 citation statements)

References 41 publications

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“…Although MR-based fat quantification is currently accepted as the noninvasive reference standard for hepatic fat quantification [ 9 30 ], it is limited by its high cost and limited accessibility. We believe that US-based technologies such as QUS may be a promising first-line tool for assessing hepatic steatosis in patients with NAFLD [ 14 ]. Our results suggest the potential application of AC-TAI and SC-TSI for screening for hepatic steatosis in patients with clinically suspected NAFLD.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, quantitative US (QUS) techniques from RF data analysis have been proposed as noninvasive and objective tools for the detection and grading of hepatic steatosis. In recent years, various QUS techniques using non-image-based parameters, including speed of sound, US attenuation, backscatter coefficient, and shear-wave dispersion, have been proposed for assessing hepatic steatosis, and they have shown a significant correlation with hepatic steatosis [ 10 12 13 14 ]. In our previous study, we demonstrated that two QUS techniques (tissue attenuation imaging [TAI] and tissue scatter-distribution imaging [TSI]) showed good diagnostic performance for detecting hepatic steatosis in patients with chronic liver disease [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Quantitative Ultrasound Radiofrequency Data Analysis for the Assessment of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Using Magnetic Resonance Imaging Proton Density Fat Fraction as the Reference Standard

et al. 2021

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Objective To investigate the diagnostic performance of quantitative ultrasound (US) parameters for the assessment of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD) using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard. Materials and Methods In this single-center prospective study, 120 patients with clinically suspected NAFLD were enrolled between March 2019 and January 2020. The participants underwent US examination for radiofrequency (RF) data acquisition and chemical shift-encoded liver MRI for PDFF measurement. Using the RF data analysis, the attenuation coefficient (AC) based on tissue attenuation imaging (TAI) (AC-TAI) and scatter-distribution coefficient (SC) based on tissue scatter-distribution imaging (TSI) (SC-TSI) were measured. The correlations between the quantitative US parameters (AC and SC) and MRI-PDFF were evaluated using Pearson correlation coefficients. The diagnostic performance of AC-TAI and SC-TSI for detecting hepatic fat contents of ≥ 5% (MRI-PDFF ≥ 5%) and ≥ 10% (MRI-PDFF ≥ 10%) were assessed using receiver operating characteristic (ROC) analysis. The significant clinical or imaging factors associated with AC and SC were analyzed using linear regression analysis. Results The participants were classified based on MRI-PDFF: < 5% (n = 38), 5–10% (n = 23), and ≥ 10% (n = 59). AC-TAI and SC-TSI were significantly correlated with MRI-PDFF ( r = 0.659 and 0.727, p < 0.001 for both). For detecting hepatic fat contents of ≥ 5% and ≥ 10%, the areas under the ROC curves of AC-TAI were 0.861 (95% confidence interval [CI]: 0.786–0.918) and 0.835 (95% CI: 0.757–0.897), and those of SC-TSI were 0.964 (95% CI: 0.913–0.989) and 0.935 (95% CI: 0.875–0.972), respectively. Multivariable linear regression analysis showed that MRI-PDFF was an independent determinant of AC-TAI and SC-TSI. Conclusion AC-TAI and SC-TSI derived from quantitative US RF data analysis yielded a good correlation with MRI-PDFF and provided good performance for detecting hepatic steatosis and assessing its severity in NAFLD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantitative Ultrasound Radiofrequency Data Analysis for the Assessment of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Using Magnetic Resonance Imaging Proton Density Fat Fraction as the Reference Standard

et al. 2021

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“…Thus, it is vital that the diagnosis and differentiation of primary lesions of liver metastases take place early to guide informed decision making. Recently, substantial advances in radiologic technology (ie, CT, MRI, and US) have significantly improved the ability to diagnose liver nodules using imaging; in particular, the liver is a focus of interest in abdominal imaging 41,42 . When hepatic metastatic lesions are detected on imaging in a timely manner, a number of treatment options are available, such as hepatic resection, hepatic artery infusion chemotherapy, and radiofrequency and microwave ablation 43,44 .…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Image–Based Radiomics

Qin

Lin

et al. 2020

J of Ultrasound Medicine

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Objectives To develop radiomic models of B‐mode ultrasound (US) signatures for determining the origin of primary tumors in metastatic liver disease. Methods A total of 254 patients with a diagnosis of metastatic liver disease were included in this retrospective study. The patients were divided into 3 groups depending on the origin of the primary tumor: group 1 (digestive tract versus non–digestive tract tumors), group 2 (breast cancer versus non–breast cancer), and group 3 (lung cancer versus other malignancies). The patients in each group were allocated to a training or testing set (a ratio of 8:2). The region of interest of liver metastasis was determined through manual differentiation of the tumors, and radiomic signatures were acquired from B‐mode US images. Optimal features were selected to develop 3 radiomic models using multiple‐dimensionality reduction and classifier screening. The area under the curve (AUC) of the receiver operating characteristic curve was applied to assess each model's performance. Results A total of 5936 features were extracted, and 40, 6, and 14 optimal features were sequentially identified for the development of radiomic models for groups 1, 2, and 3, respectively, with training set AUC values of 0.938, 0.974, and 0.768 and testing set AUC values of 0.767, 0.768, and 0.750. The differences in age, sex, and number of liver metastatic lesions varied greatly between the 4 primary tumors (P < .050). Conclusions B‐mode US radiomic models could be effective supplemental means to identify the origin of hepatic metastatic lesions (ie, unknown primary sites).

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“…The QDI may be a promising modality for use in clinical surveillance, epidemiology research, and metabolic function evaluation in patients with NAFLD. Some quantitative analysis approaches have also been used for the diagnosis of hepatic steatosis and demonstrated to correlate with several MetS components, such as controlled attenuation parameter, acoustic structure quantification, Kurtosis coefficient, and entropy 51–54 . These approaches reflect different physical properties of the liver to characterize liver tissue microstructure 55 .…”

Section: Discussionmentioning

confidence: 99%

Metabolic Characteristics of a Novel Ultrasound Quantitative Diagnostic Index for Nonalcoholic Fatty Liver Disease

Liao

Yeh

Huang

et al. 2019

Sci Rep

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Nonalcoholic fatty liver disease (NAFLD) is an emerging epidemic worldwide and is regarded as a hepatic manifestation of metabolic syndrome (MetS). Only a few studies have discussed the biological features associated with quantitative assessment of ultrasound for characterizing NAFLD. Our aim was to delineate relevant metabolic characteristics using a new quantitative tool, the ultrasound quantitative diagnostic index (QDI). A total of 394 ultrasound data were analyzed to extract texture-feature parameters, the signal-to-noise ratio (SNR), and the slope of the center frequency downshift (CFDS) for determining the QDI. The texture index, SNR, and CFDS slope were all negatively correlated with high-density lipoprotein and positively correlated with other anthropometric indices and metabolic factors (all P < 0.05). The SNR had the greatest contribution to anthropometric and biochemical factors, followed by the texture index and CFDS slope. An increase in 1 unit of QDI score engendered a 9% higher risk of MetS, reflecting that the tool is feasible for use in identifying MetS (area under the receiver operating characteristic curve: 0.89). The QDI was correlated with metabolic factors and an independent predictor for MetS. Thus, this QDI might be a feasible method for use in clinical surveillance, epidemiology research, and metabolic function evaluations in patients with NAFLD.

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Ultrasound imaging in nonalcoholic liver disease: current applications and future developments

Cited by 22 publications

References 41 publications

Quantitative Ultrasound Radiofrequency Data Analysis for the Assessment of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Using Magnetic Resonance Imaging Proton Density Fat Fraction as the Reference Standard

Quantitative Ultrasound Radiofrequency Data Analysis for the Assessment of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Using Magnetic Resonance Imaging Proton Density Fat Fraction as the Reference Standard

Ultrasound Image–Based Radiomics

Metabolic Characteristics of a Novel Ultrasound Quantitative Diagnostic Index for Nonalcoholic Fatty Liver Disease

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