Digestive diseases and sciences · 2024
Accuracy of Controlled Attenuation Parameter for Liver Steatosis in High-Risk Patients for MASLD Using MRI-Proton Density Fat Fraction as Reference Standard.
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Malandris Konstantinos, Korakas Emmanouil, Sarakapina Anna, Kalopitas Georgios, Iatridi Fotini, Liakos Aris, Bekiari Eleni, Giouleme Olga, Tzatzagou Glykeria, Karagiannis Thomas, Paschos Paschalis, Vasilakou Despoina, Lambadiari Vaia, Tzamou Elli, Daravigkas Dimitrios, Sinakos Emmanouil, Tsapas Apostolos
Аннотация
AIM: Controlled attenuation parameter (CAP) enables the noninvasive diagnosis of liver steatosis. Magnetic resonance imaging proton density fat fraction (MRI-PDFF) is increasingly used over biopsy for the assessment of steatosis in patients at risk for metabolic dysfunction-associated steatotic liver disease (MASLD). We assessed the accuracy of CAP for liver steatosis defined as MRI-PDFF ≥ 5%.
METHODS: We performed a cross-sectional, diagnostic accuracy study. We prospectively recruited consecutive adult participants with type 2 diabetes and body mass index (BMI) ≥ 25 kg/m2, who underwent CAP and MRI-PDFF within two weeks.
RESULTS: We included 113 participants. The area under the receiver operating characteristic (AUROC) of CAP for MRI-PDFF ≥ 5% was 0.82 [95% confidence interval (CI) 0.74-0.89]. CAP thresholds for ruling-out (sensitivity > 90%) and ruling-in (specificity > 90%) liver steatosis were below 249 and over 328 dB/m respectively. The AUROC of CAP for the detection of MRI-PDFF ≥ 10% was 0.81 (0.73-0.88). CAP thresholds for ruling-out and ruling-in MRI-PDFF ≥ 10% were below 271 and over 345 dB/m respectively. CAP measurements with an interquartile range (IQR) < 30 dB/m improved the detection of higher steatosis grades.
CONCLUSION: CAP has acceptable accuracy for diagnosing MRI-PDFF defined steatosis. Values below 249 dB/m can be used to rule-out liver steatosis, while values over 328 dB/m can set the diagnosis. An IQR < 30 dB/m might improve the accuracy of CAP for higher steatosis grades.
CLINICAL TRIAL REGISTRATION: Not applicable.
METHODS: We performed a cross-sectional, diagnostic accuracy study. We prospectively recruited consecutive adult participants with type 2 diabetes and body mass index (BMI) ≥ 25 kg/m2, who underwent CAP and MRI-PDFF within two weeks.
RESULTS: We included 113 participants. The area under the receiver operating characteristic (AUROC) of CAP for MRI-PDFF ≥ 5% was 0.82 [95% confidence interval (CI) 0.74-0.89]. CAP thresholds for ruling-out (sensitivity > 90%) and ruling-in (specificity > 90%) liver steatosis were below 249 and over 328 dB/m respectively. The AUROC of CAP for the detection of MRI-PDFF ≥ 10% was 0.81 (0.73-0.88). CAP thresholds for ruling-out and ruling-in MRI-PDFF ≥ 10% were below 271 and over 345 dB/m respectively. CAP measurements with an interquartile range (IQR) < 30 dB/m improved the detection of higher steatosis grades.
CONCLUSION: CAP has acceptable accuracy for diagnosing MRI-PDFF defined steatosis. Values below 249 dB/m can be used to rule-out liver steatosis, while values over 328 dB/m can set the diagnosis. An IQR < 30 dB/m might improve the accuracy of CAP for higher steatosis grades.
CLINICAL TRIAL REGISTRATION: Not applicable.