Hepatic Steatosis: Assessment with Acoustic Structure Quantification of US Imaging

To investigate the diagnostic performance of acoustic structure quantification (ASQ) for the assessment of hepatic steatosis by using hydrogen 1 ((1)H) magnetic resonance (MR) spectroscopy as the reference standard and to compare ASQ with hepatorenal ratio.

This prospective study was approved by an institutional review board, and informed written consent was obtained from all participants. ASQ and MR spectroscopy were performed in 89 participants (mean age, 41.48 years ± 14.16; 35 men, 54 women) without history of chronic liver disease. Obtained were focal disturbance (FD) ratio by using ASQ, hepatic fat fraction (HFF) by using MR spectroscopy, and hepatorenal ratio by using a histogram. Correlation coefficient, intraclass correlation coefficient, and receiver operating curve analyses were performed.

FD ratio measured with ASQ had a strong linear correlation with HFF measured with MR spectroscopy after logarithmic transformation of both variables (r = -0.87; P < .001). By using HFF of 5.79% as a cutoff value of 10% hepatic steatosis, 29 of 89 participants (32.6%) were categorized into the group with hepatic steatosis of 10% or greater (mean HFF, 13.18% ± 4.89). The area under curve of the FD ratio for diagnosing hepatic steatosis 10% or greater was 0.959 (95% confidence interval: 0.895, 0.990) with sensitivity of 86.2% (95% confidence interval: 68.3%, 96.0%) and specificity of 100% (95% confidence interval: 94.0%, 100.0%) by using a cutoff value of 0.1; the area under curve and specificity of the FD ratio were significantly higher than those of the hepatorenal ratio (respectively, 0.772 and 73.3%; respective P values, .001 and <.001).

This pilot study in a cohort of patients with hepatic steatosis without other parenchymal disease suggested ASQ may be valuable for the quantification of hepatic steatosis and detection of hepatic steatosis 10% or greater in living liver donors.