Abstract
Background / Objective
Metabolic dysfunction-associated steatotic liver disease (MASLD), or hepatic steatosis, has emerged as a significant health concern in recent decades, leading to severe consequences, including steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma, when not promptly diagnosed and managed. Liver biopsy has historically been the gold standard for assessing liver fat, but non-invasive imaging like ultrasonography, MRI, and CT scan now play a crucial role. Ultrasound B-mode imaging provides subjective estimates of liver fatty infiltration, but its accuracy varies with the expertise of the operator. Proton density fat fraction (PDFF) measured by chemical shift–encoded (CSE) MRI is recognized as a reliable biomarker for hepatic steatosis, offering superior accuracy in quantifying liver fat. This study’s aim was to evaluate the accuracy of ultrasonography in assessing hepatic steatosis compared to MRI-PDFF.
Methods
Conducted at the Institute of Diagnostic Radiology, Pauls Stradiņš Clinical University Hospital, Latvia, this retrospective study analyzed data from 199 patients who underwent abdominal MRI-PDFF scans between May and December 2023. Excluding individuals without prior abdominal ultrasonography or with ultrasonography more than 1.5 years apart from MRI, the study focused on a cohort of 106 patients.
Results
Patients’ ages ranged from 19 to 91 years (M = 59.9, SD = 15.6 years), with 62.0% being female. Among the 106 patients who underwent abdominal ultrasonography, hepatic steatosis was diagnosed in 32 (30.2%) patients. When comparing ultrasonography with MRI scan results, there were 14 true positives (TP), 17 false positives (FP), 59 true negatives (TN), and 5 false negatives (FN). Based on these figures, the positive predictive value was calculated as 45.2%, the negative predictive value as 92.2%, specificity as 77.6%, sensitivity as 73.7%, and accuracy as 76.8%
Conclusions
Over half (53,1%) of the patients diagnosed with hepatic steatosis using B-mode ultrasound did not meet the diagnostic criteria for steatosis on MRI, indicating a tendency of overdiagnosis of MASLD on ultrasonography. Our study shows that ultrasonography is less accurate and reliable compared to chemical shift-encoded MRI-PDFF for diagnosing hepatic steatosis. Notably, ultrasonography in this study was performed by physicians with varying levels of expertise.
Metabolic dysfunction-associated steatotic liver disease (MASLD), or hepatic steatosis, has emerged as a significant health concern in recent decades, leading to severe consequences, including steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma, when not promptly diagnosed and managed. Liver biopsy has historically been the gold standard for assessing liver fat, but non-invasive imaging like ultrasonography, MRI, and CT scan now play a crucial role. Ultrasound B-mode imaging provides subjective estimates of liver fatty infiltration, but its accuracy varies with the expertise of the operator. Proton density fat fraction (PDFF) measured by chemical shift–encoded (CSE) MRI is recognized as a reliable biomarker for hepatic steatosis, offering superior accuracy in quantifying liver fat. This study’s aim was to evaluate the accuracy of ultrasonography in assessing hepatic steatosis compared to MRI-PDFF.
Methods
Conducted at the Institute of Diagnostic Radiology, Pauls Stradiņš Clinical University Hospital, Latvia, this retrospective study analyzed data from 199 patients who underwent abdominal MRI-PDFF scans between May and December 2023. Excluding individuals without prior abdominal ultrasonography or with ultrasonography more than 1.5 years apart from MRI, the study focused on a cohort of 106 patients.
Results
Patients’ ages ranged from 19 to 91 years (M = 59.9, SD = 15.6 years), with 62.0% being female. Among the 106 patients who underwent abdominal ultrasonography, hepatic steatosis was diagnosed in 32 (30.2%) patients. When comparing ultrasonography with MRI scan results, there were 14 true positives (TP), 17 false positives (FP), 59 true negatives (TN), and 5 false negatives (FN). Based on these figures, the positive predictive value was calculated as 45.2%, the negative predictive value as 92.2%, specificity as 77.6%, sensitivity as 73.7%, and accuracy as 76.8%
Conclusions
Over half (53,1%) of the patients diagnosed with hepatic steatosis using B-mode ultrasound did not meet the diagnostic criteria for steatosis on MRI, indicating a tendency of overdiagnosis of MASLD on ultrasonography. Our study shows that ultrasonography is less accurate and reliable compared to chemical shift-encoded MRI-PDFF for diagnosing hepatic steatosis. Notably, ultrasonography in this study was performed by physicians with varying levels of expertise.
| Original language | English |
|---|---|
| Pages | 12 |
| Number of pages | 1 |
| Publication status | Published - 18 Oct 2024 |
| Externally published | Yes |
| Event | 9th Baltic Congress of Radiology - Riga , Latvia Duration: 17 Oct 2024 → 19 Oct 2024 https://bcr2024.lv/bcr-2024-posters/ |
Congress
| Congress | 9th Baltic Congress of Radiology |
|---|---|
| Abbreviated title | BCR2024 |
| Country/Territory | Latvia |
| City | Riga |
| Period | 17/10/24 → 19/10/24 |
| Internet address |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)