The Bubble-Destruction Curve Obtained Using Contrast-Enhanced Ultrasound is Useful for Assessing Liver Fibrosis and...

Area of Science:

• Hepatology
• Medical Imaging
• Diagnostic Tools

Background:

• Metabolic-dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic-dysfunction-associated steatohepatitis (MASH), are increasingly prevalent.
• Liver fibrosis (FIB) in MASLD predicts poor prognosis, necessitating non-invasive assessment tools.
• Early detection of at-risk MASH is crucial for effective clinical management.

Purpose of the Study:

• To evaluate a novel ultrasound (US)-based analytical tool, the bubble-destruction curve derived from contrast-enhanced US (CEUS).
• To assess the tool's capability for non-invasive liver FIB evaluation in MASLD patients.
• To identify at-risk MASH using this novel CEUS-derived parameter.

Main Methods:

• Ninety-five biopsy-proven MASLD patients underwent CEUS with Sonazoid contrast agent.
• Flash imaging during the Kupffer phase generated bubble-destruction curves, yielding parameters like bubble-destruction depth (BDD).
• BDD, slope, and accumulation were analyzed against histological FIB, biomarkers, elastography, and at-risk MASH presence.

Main Results:

• Bubble-destruction depth (BDD) significantly correlated with histological FIB stage, shear wave elastography, and FIB-4 index.
• BDD demonstrated high diagnostic performance for cirrhosis (F4) with an AUC of 0.92.
• A combined AS-BDD-MASH score (BDD, AST, sex) showed high accuracy (AUC 0.847) for at-risk MASH detection.

Conclusions:

• The CEUS-derived bubble-destruction curve is a feasible and accurate method for liver FIB assessment in MASLD.
• A composite model incorporating BDD, AST, and sex effectively identifies at-risk MASH.
• This novel approach offers a promising non-invasive strategy for managing MASLD and MASH.