Juan Chen,1,2 Yan-Hong Hao,1 Yan-Jing Zhang,1 Jing-Jing Liu,1 Ping Liang,3 Li-Ping Liu1 

1Department of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China; 2Department of Ultrasonography, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, 030001, People’s Republic of China; 3Department of Interventional Ultrasound, Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China

Correspondence: Li-Ping Liu, Department of Interventional Ultrasound, First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Taiyuan, 030001, People’s Republic of China, Tel +86 13623419190, Email liuliping1600@sina.com Ping Liang, Department of Interventional Ultrasound, Fifth Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, People’s Republic of China, Tel +86 13623419190, Email liangping301@hotmail.com

Objective: Liver steatosis analysis (LiSA) and the ultrasound-guided attenuation parameter (UGAP) are recently introduced commercially available techniques for the non-invasive evaluation of hepatic steatosis. This study aimed to assess the interplatform agreement between LiSA and UGAP in quantifying hepatic fat content.
Methods: Individuals diagnosed with or suspected of having fatty liver disease were included in the study. The overall interplatform agreement between LiSA and UGAP was assessed. The cohort was classified into 8 groups: 4 groups based on steatosis severity (S0-S3) and 4 groups based on predominant etiologies including non-alcoholic fatty liver disease, alcoholic liver disease, drug-induced fatty liver disease, and other causes. Paired-sample t-tests were used to compare LiSA and UGAP values. Interplatform agreement was evaluated using Bland‒Altman analysis with 95% limits of agreement (LOAs) and intraclass correlation coefficients (ICCs). The Pearson’s correlation coefficient was calculated to assess the relationship between LiSA and UGAP.
Results: A cohort of 357 patients with available LiSA, UGAP, and controlled attenuation parameter measurements were included in the study. No significant differences were observed between LiSA and UGAP values (p > 0.05). Pearson’s correlation coefficients ranged from ranged from 0.89 to 0.94 across all groups, while ICCs exceeded 0.80. Bland‒Altman analysis demonstrated slight biases between LiSA and UGAP, ranging from − 6.17 to 1.97 dB/m for all groups, with 95% LOAs for mean attenuation coefficient values ranging from − 40.55 to 36.09 dB/m.
Conclusion: LiSA and UGAP exhibited excellent interplatform agreement and can be used interchangeably for longitudinal monitoring of patients with hepatic steatosis.

Keywords: attenuation, fatty liver, interplatform, liver steatosis analysis, ultrasonography, ultrasound-guided attenuation parameter