Reliability of Performing Multiparametric Ultrasound in Adult Livers

Area of Science:

• Medical Imaging
• Hepatology
• Ultrasound Technology

Background:

• Multiparametric ultrasound (MPU) offers a non-invasive method for liver assessment.
• Evaluating the reliability of MPU parameters is crucial for clinical application in diagnosing liver conditions like steatosis.

Purpose of the Study:

• To assess the inter-observer and intra-observer reliability of various MPU parameters in adult livers.
• To determine the reproducibility of measurements for shear wave velocity (SWV), shear wave dispersion slope (SWD), attenuation coefficient (ATI), normalized local variance (NLV), and liver-to-kidney ratio (L/K).

Main Methods:

• 21 adult participants underwent MPU and liver magnetic resonance imaging-proton density fat fraction (MRI-PDFF) for steatosis quantification.
• Measurements included SWV, SWD, ATI, NLV, and L/K ratio.
• Intraclass correlation coefficients (ICCs) and Bland-Altman limits of agreement (LOA) were used to analyze reproducibility.

Main Results:

• ICCs for intra- and inter-observer reproducibility of most MPU parameters were above 0.75.
• SWV, ATI, and NLV demonstrated moderate to excellent repeatability and reproducibility.
• SWD and L/K ratio showed poor reliability, with wider LOA.
• Significant differences in SWV, SWD, ATI, NLV, and L/K ratio were observed between normal and steatotic livers (p < .05).

Conclusions:

• MPU parameters SWV, ATI, and NLV show promising reliability for liver assessment.
• SWD and L/K ratio measurements require further standardization to improve consistency.
• Standardized machine settings, scanning protocols, and operator training are recommended for reliable MPU of the liver.