Improved ultrasound attenuation measurement method for the non-invasive evaluation of hepatic steatosis using FibroScan ®
Abstract
Controlled Attenuation Parameter (CAP) is a measurement of ultrasound attenuation used to assess liver steatosis non-invasively. However, the standard method has some limitations. We aimed to assess the performance of a new CAP method by ex vivo and in vivo assessments. The major difference with the new method is that it uses ultrasound data continuously acquired during the imaging phase of the FibroScan examination. Seven reference tissue-mimicking phantoms were used to test the performances. In vivo performances were assessed on two cohorts (in total 195 patients) of patients using magnetic resonance imaging proton density fat fraction (MRI-PDF) as a reference. The precision of CAP was improved by more than 50% on tissue-mimicking phantoms and between 22% and 41% in the in vivo cohort studies. The agreement between both methods was excellent and the correlation between CAP and MRI-PDFF improved in both studies (0.71 to 0.74, 0.70 to 0.76). Using MRI-PDFF as a reference, the diagnostic performance of the new method was at least equal or superior (area under the receiver operating curve 0.889 to 0.900, 0.835 to 0.873). This study suggests that the new continuous CAP method can significantly improve the precision of CAP measurements ex vivo and in vivo.
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