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US Backscatter for Liver Fat Quantification: An AIUM-RSNA QIBA Pulse-Echo Quantitative Ultrasound Initiative
Keith A Wear1, Aiguo Han1, Jonathan M Rubin1
1From the Center for Devices and Radiological Health, U.S. Food and Drug Administration, 10903 New Hampshire Ave, WO62, Room 2114, Silver Spring, MD 20993 (K.A.W.); Bioacoustics Research Laboratory, Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Ill (A.H.); Department of Radiology, University of Michigan, Ann Arbor, Mich (J.M.R.); Ultrasound Research and Education, Rocky Vista University, Ivins, Utah (J.G.); Department of Engineering, Pontificia Universidad Católica del Perú, Lima, Peru (R.L.); Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, Canada (G.C.); Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Division of Radiotherapy and Imaging, Joint Department of Physics, London, UK (J.B.); and Pfizer, Cambridge, Mass (T.T.).
Quantitative ultrasound methods show promise for detecting nonalcoholic fatty liver disease (NAFLD) noninvasively. Research focuses on improving the backscatter coefficient for accurate liver fat assessment, offering a cost-effective alternative to biopsy.
Area of Science:
- Medical Imaging
- Hepatology
- Biomarkers
Background:
- Nonalcoholic fatty liver disease (NAFLD) affects a significant portion of the adult population.
- Noninvasive diagnostic methods for NAFLD are crucial for public health.
- Ultrasound (US) offers a portable and cost-effective imaging modality for liver steatosis assessment.
Purpose of the Study:
- To review the scientific principles and clinical evidence for using ultrasound backscatter parameters in assessing liver fat.
- To explore the potential of quantitative ultrasound techniques as an alternative to biopsy and MRI for NAFLD detection.
- To discuss recommendations for data collection to enhance the diagnostic performance of ultrasound in liver fat assessment.
Main Methods:
- Review of existing scientific literature and clinical studies on ultrasound backscatter for liver fat assessment.
- Analysis of quantitative ultrasound parameters such as the hepatorenal index and backscatter coefficient.
- Discussion of standardization efforts by professional organizations (AIUM, RSNA QIBA) for US acquisition and analysis.
Main Results:
- Qualitative ultrasound (B-mode echogenicity) shows association with NAFLD but suffers from interobserver variability.
- Quantitative backscatter parameters are under investigation to improve the accuracy and reproducibility of US-based liver fat characterization.
- Standardization of protocols is key to improving the diagnostic performance of the backscatter coefficient.
Conclusions:
- Quantitative ultrasound, specifically the backscatter coefficient, holds significant potential for noninvasive NAFLD detection and monitoring.
- Further standardization and research are needed to optimize US techniques for reliable liver fat assessment.
- Minimizing technical and biological confounding variables is essential for accurate quantitative ultrasound measurements.
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