Detection of pediatric hepatic steatosis through ultrasound backscattering analysis
Yao-Hung Chuang1, Chiao-Shan Hsieh2, Ming-Wei Lai3,4
1Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Insights
Ultrasound Nakagami imaging shows promise for detecting pediatric hepatic steatosis. The Nakagami parameter effectively quantifies fatty infiltration, offering a noninvasive method for assessing disease severity.
Area of Science:
- Medical Imaging
- Pediatric Gastroenterology
- Ultrasound Technology
Background:
- Pediatric hepatic steatosis is a growing health concern.
- Accurate and noninvasive diagnostic methods are needed for early detection and management.
- Ultrasound Nakagami imaging offers a potential new approach for tissue characterization.
Purpose of the Study:
- To evaluate the feasibility of ultrasound Nakagami imaging for assessing pediatric hepatic steatosis.
- To analyze echo amplitude distribution using Nakagami parameters.
- To correlate Nakagami parameters with established measures of hepatic steatosis.
Main Methods:
- 68 pediatric participants (26 healthy, 42 with hepatic steatosis) were enrolled.
- Ultrasound Nakagami imaging data were acquired using AmCAD-US software.
- Nakagami parameters were compared with hepatic steatosis index (HSI) and steatosis grade using correlation, ANOVA, and ROC analysis.
Main Results:
- Nakagami parameter significantly increased with increasing hepatic steatosis severity (G0-G4, p < .05).
- The Nakagami parameter showed high diagnostic performance for detecting various grades of hepatic steatosis (AUCs ranging from 0.82 to 0.96).
- Significant differences in Nakagami parameters were observed between different steatosis grades.
Conclusions:
- Ultrasound Nakagami imaging quantifies echo amplitude distribution changes due to fatty infiltration.
- The Nakagami parameter is a novel, noninvasive, and effective tool for detecting pediatric hepatic steatosis.
- Nakagami imaging demonstrates promising diagnostic capabilities for pediatric fatty liver disease.
Objectives:
Hepatic steatosis has become a considerable concern in the pediatric population. The objective of this study was to evaluate the feasibility of using ultrasound Nakagami imaging to produce a parametric image for analyzing the echo amplitude distribution to assess pediatric hepatic steatosis.
Methods:
A total of 68 pediatric participants were enrolled in healthy control (n = 26) and study groups (n = 42). Raw data from ultrasound imaging were acquired for each participant analysis using AmCAD-US, a software approved by the US Food and Drug Administration for ultrasound Nakagami imaging. The Nakagami parameters were compared with the hepatic steatosis index (HSI) and the steatosis grade (G0: HSI < 30; G1: 30 ≤ HSI < 36; G2: 36 ≤ HSI < 41.6; G3: 41.6 ≤ HSI < 43; G4: HSI ≥ 43) using correlation analysis, one-way analysis of variance (ANOVA), and receiver operating characteristic (ROC) curve analysis.
Results:
The Nakagami parameter increased from 0.53 ± 0.13 to 0.82 ± 0.05 with increasing severity of hepatic steatosis from G0 to G4 and were significantly different between the different grades of hepatic steatosis (p < .05). The areas under the ROC curves were 0.96, 0.92, 0.85, and 0.82 for diagnosing hepatic steatosis ≥ G1, ≥ G2, ≥ G3, and ≥ G4, respectively.
Conclusions:
The Nakagami parameter value quantifies changes in the echo amplitude distribution of ultrasound backscattered signals caused by fatty infiltration, providing a novel, noninvasive, and effective data analysis technique to detect pediatric hepatic steatosis.
Key Points:
• Ultrasound Nakagami imaging enabled quantification of the echo amplitude distribution for tissue characterization. • The Nakagami parameter increased with the increasing severity of pediatric hepatic steatosis. • The Nakagami parameter demonstrated promising diagnostic performance in evaluating pediatric hepatic steatosis.
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