European radiology · 2025
Optimization of measurements with an ultrasound attenuation coefficient algorithm for quantifying liver fat.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ferraioli Giovanna, Roccarina Davide, Kumada Takashi, Ogawa Sadanobu, Yoshida Yuichi, Hirooka Masashi, Barr Richard G
Аннотация
OBJECTIVES: Methods for measuring the ultrasound attenuation coefficient (AC) vary across different systems. Some have fixed regions of interest (ROI) while others have movable ROIs. Aims were to evaluate whether, using a system with a fixed ROI, correlation between AC and MRI proton density fat fraction (MRI-PDFF), and performance could be improved by (i) reducing fixed ROI length to 30 mm, changing starting point from the transducer, and (ii) using a movable ROI at different depths.
MATERIALS AND METHODS: In this retrospective multicenter study, AC measurements were performed with the Arietta 850 system, and raw data were automatically stored. AC values were obtained using a standard commercial algorithm (ROI-setting1, 35-75 mm from transducer). Raw data were successively reprocessed externally using a fixed 45-75 mm ROI (ROI-setting2) and a movable 30 mm ROI positioned with the top at 20 mm (ROI-setting3) and 25 mm below the liver capsule (ROI-setting4). Spearman rho and area under the receiver operating characteristics curve (AUROC) were used to assess correlation with MRI-PDFF and performance, respectively, and the Delong test was used to compare AUROCs.
RESULTS: Seven hundred fifty participants (median age: 65 [52, 73] years; 384 males) were included. Correlation of ROI-setting1 with MRI-PDFF was 0.75 (0.72, 0.78), reaching 0.80 (0.77, 0.82) with ROI-setting4. Overall, ROI-setting4 showed significantly the best performance across steatosis grades. AUROCs for S > 0 were 0.90 (0.87, 0.92) for ROI-setting1 and 0.92 (0.90, 0.94) with ROI-setting4 (p < 0.001). This latter performed significantly better than all other settings in participants with obesity and skin-to-liver distance > 25 mm (p < 0.05).
CONCLUSIONS: A movable ROI improves both AC correlation with MRI-PDFF and performance. The highest improvement was with the ROI top 25 mm below the liver capsule.
KEY POINTS: Question It remains uncertain whether utilizing an ROI at a fixed position from the transducer is optimal for ultrasound AC measurements. Findings The highest AC performance and correlation with MRI-PDFF were observed with a movable ROI positioned with the top at 25 mm under the liver capsule. Clinical relevance A movable ROI with consistent sub-capsular placement improves both correlation between AC and MRI-PDFF, as well as its performance, whereas in individuals with a skin-to-liver capsule distance > 25 mm, a fixed ROI position significantly decreases AC performance.
MATERIALS AND METHODS: In this retrospective multicenter study, AC measurements were performed with the Arietta 850 system, and raw data were automatically stored. AC values were obtained using a standard commercial algorithm (ROI-setting1, 35-75 mm from transducer). Raw data were successively reprocessed externally using a fixed 45-75 mm ROI (ROI-setting2) and a movable 30 mm ROI positioned with the top at 20 mm (ROI-setting3) and 25 mm below the liver capsule (ROI-setting4). Spearman rho and area under the receiver operating characteristics curve (AUROC) were used to assess correlation with MRI-PDFF and performance, respectively, and the Delong test was used to compare AUROCs.
RESULTS: Seven hundred fifty participants (median age: 65 [52, 73] years; 384 males) were included. Correlation of ROI-setting1 with MRI-PDFF was 0.75 (0.72, 0.78), reaching 0.80 (0.77, 0.82) with ROI-setting4. Overall, ROI-setting4 showed significantly the best performance across steatosis grades. AUROCs for S > 0 were 0.90 (0.87, 0.92) for ROI-setting1 and 0.92 (0.90, 0.94) with ROI-setting4 (p < 0.001). This latter performed significantly better than all other settings in participants with obesity and skin-to-liver distance > 25 mm (p < 0.05).
CONCLUSIONS: A movable ROI improves both AC correlation with MRI-PDFF and performance. The highest improvement was with the ROI top 25 mm below the liver capsule.
KEY POINTS: Question It remains uncertain whether utilizing an ROI at a fixed position from the transducer is optimal for ultrasound AC measurements. Findings The highest AC performance and correlation with MRI-PDFF were observed with a movable ROI positioned with the top at 25 mm under the liver capsule. Clinical relevance A movable ROI with consistent sub-capsular placement improves both correlation between AC and MRI-PDFF, as well as its performance, whereas in individuals with a skin-to-liver capsule distance > 25 mm, a fixed ROI position significantly decreases AC performance.