Ultrasound parametric imaging of hepatic steatosis using the homodyned-K distribution: An animal study

Hepatic steatosis is an abnormal state where excess lipid mass is accumulated in hepatocyte vesicles. Backscattered ultrasound signals received from the liver contain useful information regarding the degree of steatosis in the liver. The homodyned-K (HK) distribution has been demonstrated as a general model for ultrasound backscattering. The estimator based on the first three integer moments (denoted as "FTM") of the intensity has potential for practical applications because of its simplicity and low computational complexity. This study explored the diagnostic performance of HK parametric imaging based on the FTM method in the assessment of hepatic steatosis. Phantom experiments were initially conducted using the sliding window technique to determine an appropriate window size length (WSL) for HK parametric imaging. Subsequently, hepatic steatosis was induced in male Wistar rats fed a methionine- and choline-deficient (MCD) diet for 0 (i.e., normal control), 1, 2, 4, 6, and 8 weeks (n = 36; six rats in each group). After completing the scheduled MCD diet, ultrasound B-mode and HK imaging of the rat livers were performed in vivo and histopathological examinations were conducted to score the degree of hepatic steatosis. HK parameters μ (related to scatterer number density) and k (related to scatterer periodicity) were expressed as functions of the steatosis stage in terms of the median and interquartile range (IQR). Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance levels of the μ and k parameters. The results showed that an appropriate WSL for HK parametric imaging is seven times the pulse length of the transducer. The median value of the μ parameter increased monotonically from 0.194 (IQR: 0.18-0.23) to 0.893 (IQR: 0.64-1.04) as the steatosis stage increased. Concurrently, the median value of the k parameter increased from 0.279 (IQR: 0.26-0.31) to 0.5 (IQR: 0.41-0.54) in the early stages (normal to mild) and decreased to 0.39 (IQR: 0.29-0.45) in the advanced stages (moderate to severe). The areas under the ROC curves obtained using (μ, k) were (0.947, 0.804), (0.914, 0.575), and (0.813, 0.604) for the steatosis stages of ≥mild, ≥moderate, and ≥severe, respectively. The current findings suggest that ultrasound HK parametric imaging based on FTM estimation has great potential for future clinical diagnoses of hepatic steatosis.