Detection of hepatic steatosis with ultrasound attenuation imaging compared to MRI

Purpose: The main objective of this study was to evaluate the utility of a novel ultrasound technique, Attenuation Imaging (ATI), for detecting hepatic steatosis, comparing the results with magnetic resonance imaging (MRI) as the reference standard. ATI is a non-invasive, lower-cost, and potentially more available method with a shorter examination time than MRI. Materials and Methods: A diagnostic test design was employed in a sample of 143 randomly selected patients who underwent both MRI and ATI. This diagnostic test study was conducted and reported in accordance with the STARD (Standards for Reporting of Diagnostic Accuracy) initiative. Pearson's correlation was used to compare the values obtained through ATI and MRI, and regression models was applied to assess interaction and confounding variables. Diagnostic performance was analyzed using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUROC). Results: The ATI and MRI measurements showed a strong correlation (R-squared = 0.9841, p < 0.001). The non-linear regression analysis generated a formula to estimate the percentage of steatosis in MRI based on the steatosis measured by ATI. The ROC analysis revealed an AUROC of 0.8251 (95% CI: 0.75457-0.89565). Conclusion: The ATI technique demonstrated a strong correlation with MRI for the detection of hepatic steatosis. The non-linear regression used in the study allowed for generating a formula that estimates the percentage of steatosis in MRI based on the steatosis measured by ATI. This indicates that ATI may serve as a more accessible and cost-effective alternative to MRI in detecting and monitoring hepatic steatosis in patients with non-alcoholic liver disease. Clinical Relevance: ATI offers a cost-effective, non-invasive, and accurate diagnostic method for detecting hepatic steatosis, potentially improving access to early diagnosis and treatment.