Ultrasound-guided attenuation parameter (UGAP) for identifying metabolic dysfunction-associated steatotic liver disease: a prospective study

Huang, Yun-Lin; Sun, Chao; Wang, Ying; Cheng, Juan; Wang, Shi-Wen; Wei, Li; Lu, Xiu-Yun; Cheng, Rui; Wang, Ming; Fan, Jian-Gao; Dong, Yi

doi:.0.0.0

Original Article

Ultrasound-guided attenuation parameter (UGAP) for identifying metabolic dysfunction-associated steatotic liver disease: a prospective study

Yun-Lin Huang¹

, Chao Sun²

, Ying Wang¹, Juan Cheng¹, Shi-Wen Wang¹, Li Wei¹, Xiu-Yun Lu¹, Rui Cheng¹, Ming Wang¹, Jian-Gao Fan²

, Yi Dong¹

¹Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
²Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, 1665 Kong Jiang Road, Shanghai, China, Shanghai, China

Corresponding Author: Yi Dong ,Tel: 86 (0)21- 25076104, Fax: 86 (0)21- 25076104, Email: drdaisydong@hotmail.com

Received: November 12, 2024; Accepted: December 19, 2024. Published online: December 19, 2024.

ABSTRACT

Purpose:
To evaluate the performance of ultrasound-guided attenuation parameter (UGAP) for diagnosing and grading hepatic steatosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference.
Methods:
Patients with hepatic steatosis were enrolled in this prospective study and underwent UGAP measurements. Taking MRI-PDFF ≥ 5 %, ≥ 15 %, and ≥ 25 % as the reference for diagnosing steatosis grade ≥ S1, ≥ S2, and S3, respectively. Spearman correlation and area under the receiver operating characteristic curves (AUCs) were performed.
Results:
From July 2023 to June 2024, 88 patients (median age: 40 years, interquartile range [IQR]: 36 – 46]; 54.5 % [48/88] men and 45.5 % [40/88] women) were included; 22.7 % (20/88), 50.0 % (44/88), 21.6 % (19/88), and 5.7 % (5/88) of patients had S0, S1, S2, and S3, respectively. The successful rate of UGAP measurements was 100 %. The median UGAP value was 0.74 dB/cm/MHz (IQR: 0.65 – 0.82). UGAP values were positively correlated with MRI-PDFF (r = 0.77, P < 0.001). The AUCs of UGAP for diagnosing steatosis grade ≥ S1, ≥ S2, and S3 were 0.91, 0.90, and 0.88, respectively. In the subgroup, 98.4 % (60/61) of patients had valid controlled attenuation parameter (CAP) values. UGAP values were positively correlated with CAP values (r = 0.65, P < 0.001).
Conclusion:
UDFF has excellent diagnostic performance in detecting and grading hepatic steatosis using MRI-PDFF as the reference standard and can be potentially used in clinical practice.

Keywords: Ultrasound-guided attenuation parameter; Magnetic resonance imaging proton density fat fra; Controlled attenuation parameter; Metabolic dysfunction-associated steatotic liver ; Quantification; Noninvasive