iATT liver fat quantification for steatosis grading by referring to MRI proton density fat fraction: a multicenter study
Background Several preliminary reports have suggested the utility of ultrasound attenuation coefficient measurements based on B-mode ultrasound, such as iATT, for diagnosing steatotic liver disease. Nonetheless, evidence supporting such utility is lacking. This prospective study aimed to investigate...
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| Veröffentlicht in: | Journal of gastroenterology 2024-06, Vol.59 (6), p.504-514 |
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| creator | Hirooka, Masashi Ogawa, Sadanobu Koizumi, Yohei Yoshida, Yuichi Goto, Tatsuya Yasuda, Satoshi Yamahira, Masahiro Tamai, Tsutomu Kuromatsu, Ryoko Matsuzaki, Toshihisa Suehiro, Tomoyuki Kamada, Yoshihiro Sumida, Yoshio Hiasa, Yoichi Toyoda, Hidenori Kumada, Takashi |
| description | Background
Several preliminary reports have suggested the utility of ultrasound attenuation coefficient measurements based on B-mode ultrasound, such as iATT, for diagnosing steatotic liver disease. Nonetheless, evidence supporting such utility is lacking. This prospective study aimed to investigate whether iATT is highly concordant with magnetic resonance imaging (MRI)-based proton density fat fraction (MRI-PDFF) and could well distinguish between steatosis grades.
Methods
A cohort of 846 individuals underwent both iATT and MRI-PDFF assessments. Steatosis grade was defined as grade 0 with MRI-PDFF |
| doi_str_mv | 10.1007/s00535-024-02096-w |
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Several preliminary reports have suggested the utility of ultrasound attenuation coefficient measurements based on B-mode ultrasound, such as iATT, for diagnosing steatotic liver disease. Nonetheless, evidence supporting such utility is lacking. This prospective study aimed to investigate whether iATT is highly concordant with magnetic resonance imaging (MRI)-based proton density fat fraction (MRI-PDFF) and could well distinguish between steatosis grades.
Methods
A cohort of 846 individuals underwent both iATT and MRI-PDFF assessments. Steatosis grade was defined as grade 0 with MRI-PDFF < 5.2%, grade 1 with 5.2% MRI-PDFF < 11.3%, grade 2 with 11.3% MRI-PDFF < 17.1%, and grade 3 with MRI-PDFF of 17.1%. The reproducibility of iATT and MRI-PDFF was evaluated using the Bland–Altman analysis and intraclass correlation coefficients, whereas the diagnostic performance of each steatosis grade was examined using receiver operating characteristic analysis.
Results
The Bland–Altman analysis indicated excellent reproducibility with minimal fixed bias between iATT and MRI-PDFF. The area under the curve for distinguishing steatosis grades 1, 2, and 3 were 0.887, 0.882, and 0.867, respectively. A skin-to-capsula distance of ≥ 25 mm was identified as the only significant factor causing the discrepancy. No interaction between MRI-logPDFF and MRE-LSM on iATT values was observed.
Conclusions
Compared to MRI-PDFF, iATT showed excellent diagnostic accuracy in grading steatosis. iATT could be used as a diagnostic tool instead of MRI in clinical practice and trials.
Trial registration
This study was registered in the UMIN Clinical Trials Registry (UMIN000047411).</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-024-02096-w</identifier><identifier>PMID: 38553657</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Abdominal Surgery ; Adipose Tissue - diagnostic imaging ; Adipose Tissue - pathology ; Adult ; Aged ; Biliary Tract ; Clinical trials ; Colorectal Surgery ; Fatty liver ; Fatty Liver - diagnostic imaging ; Fatty Liver - pathology ; Female ; Gastroenterology ; Hepatology ; Humans ; Liver - diagnostic imaging ; Liver - pathology ; Liver diseases ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Non-alcoholic Fatty Liver Disease - diagnostic imaging ; Non-alcoholic Fatty Liver Disease - pathology ; Original Article―Liver ; Original ―Liver, Pancreas, and Biliary Tract ; Pancreas ; Prospective Studies ; Reproducibility ; Reproducibility of Results ; ROC Curve ; Severity of Illness Index ; Steatosis ; Surgical Oncology ; Ultrasonic imaging ; Ultrasonography - methods ; Ultrasound ; UMIN ; UMIN000047411</subject><ispartof>Journal of gastroenterology, 2024-06, Vol.59 (6), p.504-514</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-3ea019e1d9dc3fc48ace646bcf9b3b2acc795341030a95b57333b65624e3a5d33</cites><orcidid>0000-0001-5634-5313</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-024-02096-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-024-02096-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38553657$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hirooka, Masashi</creatorcontrib><creatorcontrib>Ogawa, Sadanobu</creatorcontrib><creatorcontrib>Koizumi, Yohei</creatorcontrib><creatorcontrib>Yoshida, Yuichi</creatorcontrib><creatorcontrib>Goto, Tatsuya</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Yamahira, Masahiro</creatorcontrib><creatorcontrib>Tamai, Tsutomu</creatorcontrib><creatorcontrib>Kuromatsu, Ryoko</creatorcontrib><creatorcontrib>Matsuzaki, Toshihisa</creatorcontrib><creatorcontrib>Suehiro, Tomoyuki</creatorcontrib><creatorcontrib>Kamada, Yoshihiro</creatorcontrib><creatorcontrib>Sumida, Yoshio</creatorcontrib><creatorcontrib>Hiasa, Yoichi</creatorcontrib><creatorcontrib>Toyoda, Hidenori</creatorcontrib><creatorcontrib>Kumada, Takashi</creatorcontrib><title>iATT liver fat quantification for steatosis grading by referring to MRI proton density fat fraction: a multicenter study</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
Several preliminary reports have suggested the utility of ultrasound attenuation coefficient measurements based on B-mode ultrasound, such as iATT, for diagnosing steatotic liver disease. Nonetheless, evidence supporting such utility is lacking. This prospective study aimed to investigate whether iATT is highly concordant with magnetic resonance imaging (MRI)-based proton density fat fraction (MRI-PDFF) and could well distinguish between steatosis grades.
Methods
A cohort of 846 individuals underwent both iATT and MRI-PDFF assessments. Steatosis grade was defined as grade 0 with MRI-PDFF < 5.2%, grade 1 with 5.2% MRI-PDFF < 11.3%, grade 2 with 11.3% MRI-PDFF < 17.1%, and grade 3 with MRI-PDFF of 17.1%. The reproducibility of iATT and MRI-PDFF was evaluated using the Bland–Altman analysis and intraclass correlation coefficients, whereas the diagnostic performance of each steatosis grade was examined using receiver operating characteristic analysis.
Results
The Bland–Altman analysis indicated excellent reproducibility with minimal fixed bias between iATT and MRI-PDFF. The area under the curve for distinguishing steatosis grades 1, 2, and 3 were 0.887, 0.882, and 0.867, respectively. A skin-to-capsula distance of ≥ 25 mm was identified as the only significant factor causing the discrepancy. No interaction between MRI-logPDFF and MRE-LSM on iATT values was observed.
Conclusions
Compared to MRI-PDFF, iATT showed excellent diagnostic accuracy in grading steatosis. iATT could be used as a diagnostic tool instead of MRI in clinical practice and trials.
Trial registration
This study was registered in the UMIN Clinical Trials Registry (UMIN000047411).</description><subject>Abdominal Surgery</subject><subject>Adipose Tissue - diagnostic imaging</subject><subject>Adipose Tissue - pathology</subject><subject>Adult</subject><subject>Aged</subject><subject>Biliary Tract</subject><subject>Clinical trials</subject><subject>Colorectal Surgery</subject><subject>Fatty liver</subject><subject>Fatty Liver - diagnostic imaging</subject><subject>Fatty Liver - pathology</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - pathology</subject><subject>Liver diseases</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Non-alcoholic Fatty Liver Disease - diagnostic imaging</subject><subject>Non-alcoholic Fatty Liver Disease - pathology</subject><subject>Original Article―Liver</subject><subject>Original ―Liver, Pancreas, and Biliary Tract</subject><subject>Pancreas</subject><subject>Prospective Studies</subject><subject>Reproducibility</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>Steatosis</subject><subject>Surgical Oncology</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - methods</subject><subject>Ultrasound</subject><subject>UMIN</subject><subject>UMIN000047411</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kUtv1DAUhS0EosPAH2CBLLFhE_A7CRtUVTwqFSGhYW3dODeDq0w8tZ2W-fc4nVIeCxaWZfvc43vPR8hzzl5zxuo3iTEtdcWEKou1prp5QFZclSvdCvGQrFirVMV5rU7Ik5QuGeOS6eYxOZGN1tLoekV--NPNho7-GiMdINOrGabsB-8g-zDRIUSaMkIOySe6jdD7aUu7A404YIzLIQf6-es53ceQS0GPU_L5cOs1RHCLy1sKdDeP2TucMi6Gc394Sh4NMCZ8drevybcP7zdnn6qLLx_Pz04vKqeEyZVEYLxF3re9k4NTDTg0ynRuaDvZCXCubrVUnEkGre50LaXsjDZCoQTdS7km746--7nbYb-0EGG0--h3EA82gLd_v0z-u92Ga8s5F40qCa_JqzuHGK5mTNnufHI4jjBhmJOVTAhdq5Jnkb78R3oZ5jiV-YrKFEgNN6aoxFHlYkipJHnfDWd2IWuPZG0ha2_J2ptS9OLPOe5LfqEsAnkUpP3CBePvv_9j-xOVb7F0</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Hirooka, Masashi</creator><creator>Ogawa, Sadanobu</creator><creator>Koizumi, Yohei</creator><creator>Yoshida, Yuichi</creator><creator>Goto, Tatsuya</creator><creator>Yasuda, Satoshi</creator><creator>Yamahira, Masahiro</creator><creator>Tamai, Tsutomu</creator><creator>Kuromatsu, Ryoko</creator><creator>Matsuzaki, Toshihisa</creator><creator>Suehiro, Tomoyuki</creator><creator>Kamada, Yoshihiro</creator><creator>Sumida, Yoshio</creator><creator>Hiasa, Yoichi</creator><creator>Toyoda, Hidenori</creator><creator>Kumada, Takashi</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5634-5313</orcidid></search><sort><creationdate>20240601</creationdate><title>iATT liver fat quantification for steatosis grading by referring to MRI proton density fat fraction: a multicenter study</title><author>Hirooka, Masashi ; Ogawa, Sadanobu ; Koizumi, Yohei ; Yoshida, Yuichi ; Goto, Tatsuya ; Yasuda, Satoshi ; Yamahira, Masahiro ; Tamai, Tsutomu ; Kuromatsu, Ryoko ; Matsuzaki, Toshihisa ; Suehiro, Tomoyuki ; Kamada, Yoshihiro ; Sumida, Yoshio ; Hiasa, Yoichi ; Toyoda, Hidenori ; Kumada, Takashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-3ea019e1d9dc3fc48ace646bcf9b3b2acc795341030a95b57333b65624e3a5d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Adipose Tissue - diagnostic imaging</topic><topic>Adipose Tissue - pathology</topic><topic>Adult</topic><topic>Aged</topic><topic>Biliary Tract</topic><topic>Clinical trials</topic><topic>Colorectal Surgery</topic><topic>Fatty liver</topic><topic>Fatty Liver - diagnostic imaging</topic><topic>Fatty Liver - pathology</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - pathology</topic><topic>Liver diseases</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Non-alcoholic Fatty Liver Disease - diagnostic imaging</topic><topic>Non-alcoholic Fatty Liver Disease - pathology</topic><topic>Original Article―Liver</topic><topic>Original ―Liver, Pancreas, and Biliary Tract</topic><topic>Pancreas</topic><topic>Prospective Studies</topic><topic>Reproducibility</topic><topic>Reproducibility of Results</topic><topic>ROC Curve</topic><topic>Severity of Illness Index</topic><topic>Steatosis</topic><topic>Surgical Oncology</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - methods</topic><topic>Ultrasound</topic><topic>UMIN</topic><topic>UMIN000047411</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hirooka, Masashi</creatorcontrib><creatorcontrib>Ogawa, Sadanobu</creatorcontrib><creatorcontrib>Koizumi, Yohei</creatorcontrib><creatorcontrib>Yoshida, Yuichi</creatorcontrib><creatorcontrib>Goto, Tatsuya</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Yamahira, Masahiro</creatorcontrib><creatorcontrib>Tamai, Tsutomu</creatorcontrib><creatorcontrib>Kuromatsu, Ryoko</creatorcontrib><creatorcontrib>Matsuzaki, Toshihisa</creatorcontrib><creatorcontrib>Suehiro, Tomoyuki</creatorcontrib><creatorcontrib>Kamada, Yoshihiro</creatorcontrib><creatorcontrib>Sumida, Yoshio</creatorcontrib><creatorcontrib>Hiasa, Yoichi</creatorcontrib><creatorcontrib>Toyoda, Hidenori</creatorcontrib><creatorcontrib>Kumada, Takashi</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hirooka, Masashi</au><au>Ogawa, Sadanobu</au><au>Koizumi, Yohei</au><au>Yoshida, Yuichi</au><au>Goto, Tatsuya</au><au>Yasuda, Satoshi</au><au>Yamahira, Masahiro</au><au>Tamai, Tsutomu</au><au>Kuromatsu, Ryoko</au><au>Matsuzaki, Toshihisa</au><au>Suehiro, Tomoyuki</au><au>Kamada, Yoshihiro</au><au>Sumida, Yoshio</au><au>Hiasa, Yoichi</au><au>Toyoda, Hidenori</au><au>Kumada, Takashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>iATT liver fat quantification for steatosis grading by referring to MRI proton density fat fraction: a multicenter study</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>59</volume><issue>6</issue><spage>504</spage><epage>514</epage><pages>504-514</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background
Several preliminary reports have suggested the utility of ultrasound attenuation coefficient measurements based on B-mode ultrasound, such as iATT, for diagnosing steatotic liver disease. Nonetheless, evidence supporting such utility is lacking. This prospective study aimed to investigate whether iATT is highly concordant with magnetic resonance imaging (MRI)-based proton density fat fraction (MRI-PDFF) and could well distinguish between steatosis grades.
Methods
A cohort of 846 individuals underwent both iATT and MRI-PDFF assessments. Steatosis grade was defined as grade 0 with MRI-PDFF < 5.2%, grade 1 with 5.2% MRI-PDFF < 11.3%, grade 2 with 11.3% MRI-PDFF < 17.1%, and grade 3 with MRI-PDFF of 17.1%. The reproducibility of iATT and MRI-PDFF was evaluated using the Bland–Altman analysis and intraclass correlation coefficients, whereas the diagnostic performance of each steatosis grade was examined using receiver operating characteristic analysis.
Results
The Bland–Altman analysis indicated excellent reproducibility with minimal fixed bias between iATT and MRI-PDFF. The area under the curve for distinguishing steatosis grades 1, 2, and 3 were 0.887, 0.882, and 0.867, respectively. A skin-to-capsula distance of ≥ 25 mm was identified as the only significant factor causing the discrepancy. No interaction between MRI-logPDFF and MRE-LSM on iATT values was observed.
Conclusions
Compared to MRI-PDFF, iATT showed excellent diagnostic accuracy in grading steatosis. iATT could be used as a diagnostic tool instead of MRI in clinical practice and trials.
Trial registration
This study was registered in the UMIN Clinical Trials Registry (UMIN000047411).</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>38553657</pmid><doi>10.1007/s00535-024-02096-w</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-5634-5313</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of gastroenterology, 2024-06, Vol.59 (6), p.504-514 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Abdominal Surgery Adipose Tissue - diagnostic imaging Adipose Tissue - pathology Adult Aged Biliary Tract Clinical trials Colorectal Surgery Fatty liver Fatty Liver - diagnostic imaging Fatty Liver - pathology Female Gastroenterology Hepatology Humans Liver - diagnostic imaging Liver - pathology Liver diseases Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Middle Aged Non-alcoholic Fatty Liver Disease - diagnostic imaging Non-alcoholic Fatty Liver Disease - pathology Original Article―Liver Original ―Liver, Pancreas, and Biliary Tract Pancreas Prospective Studies Reproducibility Reproducibility of Results ROC Curve Severity of Illness Index Steatosis Surgical Oncology Ultrasonic imaging Ultrasonography - methods Ultrasound UMIN UMIN000047411 |
| title | iATT liver fat quantification for steatosis grading by referring to MRI proton density fat fraction: a multicenter study |
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