@article{ede73481f88f4cd4a7ee70f4de812545,
title = "Direct Comparison of Quantitative US versus Controlled Attenuation Parameter for Liver Fat Assessment Using MRI Proton Density Fat Fraction as the Reference Standard in Patients Suspected of Having NAFLD",
abstract = "Background: MRI-derived proton density fat fraction (PDFF) is an accurate, reliable, and safe biologic marker for use in the noninvasive diagnosis of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD). Because of the cost and limited availability of MRI, it is necessary to develop an accurate method to diagnose NAFLD with potential point-of-care access. Purpose: To compare the diagnostic accuracy of the quantitative US (QUS) fat fraction (FF) estimator with that of the controlled attenuation parameter (CAP) in the diagnosis of NAFLD using contemporaneous MRI-derived PDFF as the reference standard. Materials and Methods: Participants with or suspected of having NAFLD were prospectively recruited at the NAFLD Research Center between July 2015 and July 2019. All participants underwent MRI-derived PDFF measurement, transient elastography with CAP measurement, and QUS. QUS FF was derived using computed QUS parameters from the acquired radiofrequency US data using a calibrated reference phantom. The area under the receiver operating characteristic curve (AUC) was calculated to assess the accuracy of QUS FF and CAP in the diagnosis of hepatic steatosis (defined as MRI-derived PDFF ≥ 5%). AUCs were compared using the DeLong test. Results: A total of 123 participants were included (mean age, 52 years 6 13 [SD]; 67 [54%] women). Of these participants, 100 (81%) had MRI-derived PDFF of 5% or more. QUS FF had a significantly higher AUC for diagnosis of NAFLD than did CAP (0.92 [95% CI: 0.87, 0.98] vs 0.79 [95% CI: 0.67, 0.90], P = .03). QUS FF had a sensitivity of 98% (98 of 100) and a specificity of 48% (11 of 23). CAP had a sensitivity of 87% (87 of 100) and a specificity of 57% (13 of 23). Conclusion: The quantitative US fat fraction estimator is more accurate than the controlled attenuation parameter in the diagnosis of hepatic steatosis in patients with or suspected of having nonalcoholic fatty liver disease.",
author = "Jinho Jung and Aiguo Han and Egbert Madamba and Ricki Bettencourt and Loomba, {Rohan R.} and Boehringer, {Andrew S.} and Andre, {Michael P.} and Erdman, {John W.} and O{\textquoteright}Brien, {William D.} and Fowler, {Kathryn J.} and Sirlin, {Claude B.} and Rohit Loomba",
note = "Funding Information: Supported by National Institute of Diabetes and Digestive and Kidney Disease (R01DK106419) and Siemens Healthineers. Funding Information: Disclosures of conflicts of interest: J.J. No relevant relationships. A.H. No relevant relationships. E.M. No relevant relationships. R.B. No relevant relationships. R.R.L. No relevant relationships. A.S.B. No relevant relationships. M.P.A. No relevant relationships. J.W.E. No relevant relationships. W.D.O. No relevant relationships. K.J.F. Member of Radiology editorial board; consultant for GE Healthcare; grants from Median, Pfizer, GE, and Bayer. C.B.S. Consultant to Blade, Boehringer, and Epigenomics; grants from GE, Siemens, Philips, Bayer, Gilead, and Pfizer; lectures for Pfizer and Medscape; royalties from Wolt-ers Kluwer; stock in Livivos; travel expenses paid by Sun Yat-Sen University; lab service agreements with Enanta, Gilead, ICON, Intercept, Nusirt, Shire, Synageva, and Takeda; consulting under auspices of institution for Advanced Magnetic Resonance Analytics, Bristol Myers Squibb, Exact Sciences, GE Digital, and IBM Watson; unpaid advisor to Quantix Bio. R.L. Institution received grants from Arrowhead Pharmaceuticals, AstraZeneca, Boehringer-Ingelheim, Bristol Myers Squibb, Eli Lilly, Galectin Therapeutics, Galmed Pharmaceuticals, Gilead, Hanmi, Intercept, Inventiva, Ionis, Janssen, Madrigal Pharmaceuticals, Merck, NGM Biopharmaceuticals, Novo Nordisk, Merck, Pfizer, Sonic Incytes, and Terns Pharmaceuticals; consultant to Aardvark Therapeutics, Altimmune, Anylam/Regeneron, Amgen, Arrowhead Pharmaceuticals, AstraZeneca, Bristol Myers Squibb, CohBar, Eli Lilly, Galmed, Gilead, Glympse Bio, Hightide, Ini-pharma, Intercept, Inventiva, Ionis, Janssen, Madrigal, Metacrine, NGM Bio-pharmaceuticals, Novartis, Novo Nordisk, Merck, Pfizer, Sagimet, Theratech-nologies, 89 Bio, Terns Pharmaceuticals, and Viking Therapeutics; cofounder of LipoNexus. Funding Information: This was a Health Insurance Portability and Accountability Act–compliant and institutional review board–approved prospective cross-sectional study that included a well-characterized cohort with or suspected of having NAFLD. Our study was supported in part by Siemens Healthineers through a research grant and a US scanner loaned to the University of California at San Diego. The authors controlled the information submitted for publication. Publisher Copyright: {\textcopyright} RSNA, 2022.",
year = "2022",
month = jul,
doi = "10.1148/radiol.211131",
language = "English (US)",
volume = "304",
pages = "75--82",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "1",
}