Reproducibility and accuracy of a pocket-size ultrasound device in assessing liver steatosis.

Controlled-attenuation parameter Liver biopsy Non-alcoholic fatty liver disease Pocket size ultrasound devices Steatosis Ultrasound Vibration-controlled transient elastography

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
27 Nov 2023
Historique:
received: 25 08 2023
revised: 07 11 2023
accepted: 09 11 2023
medline: 29 11 2023
pubmed: 29 11 2023
entrez: 28 11 2023
Statut: aheadofprint

Résumé

This diagnostic prospective study compared the feasibility and diagnostic accuracy of Pocket-size Ultrasound Devices (PUDs) against standard ultrasound (US) in detecting liver steatosis using the controlled attenuation parameter (CAP) and liver biopsy as reference standards. Consecutive patients with chronic liver diseases were assessed for the presence of steatosis using PUD and US. A CAP cut-off value >275 dB/m was applied to establish ≥S1. A 26-patient subgroup underwent liver biopsy. PUD reproducibility was evaluated using Cohen's k statistic. Diagnostic accuracy of PUD and US was given as Sensibility (Sn), Specificity (Sp), Positive and Negative Predictive Values (PPV, NPV), positive and negative Likelihood Ratio (LR+, LR-). 81 consecutive patients (69% males) with multiple etiologies were enroled. PUD inter-observer agreement was good (k 0.77, 95%CI 0.62-0.93). PUD and US identified ≥S1 according to CAP values respectively with Sn 0.87, Sp 0.61, PPV 0.49, NPV 0.91, LR+ 2.04, LR- 0.07, AUROC 0.74 and Sn 0.96, Sp 0.54, PPV 0.47, NPV 0.97, LR+ 2.10, LR- 0.07, AUROC 0.75. PUD shows good reproducibility and diagnostic accuracy in ruling liver steatosis out, representing a useful point-of-care tool to avail of hepatologists interested in excluding NAFLD, but with basic US skills.

Sections du résumé

BACKGROUND BACKGROUND
This diagnostic prospective study compared the feasibility and diagnostic accuracy of Pocket-size Ultrasound Devices (PUDs) against standard ultrasound (US) in detecting liver steatosis using the controlled attenuation parameter (CAP) and liver biopsy as reference standards.
MATERIALS AND METHODS METHODS
Consecutive patients with chronic liver diseases were assessed for the presence of steatosis using PUD and US. A CAP cut-off value >275 dB/m was applied to establish ≥S1. A 26-patient subgroup underwent liver biopsy. PUD reproducibility was evaluated using Cohen's k statistic. Diagnostic accuracy of PUD and US was given as Sensibility (Sn), Specificity (Sp), Positive and Negative Predictive Values (PPV, NPV), positive and negative Likelihood Ratio (LR+, LR-).
RESULTS RESULTS
81 consecutive patients (69% males) with multiple etiologies were enroled. PUD inter-observer agreement was good (k 0.77, 95%CI 0.62-0.93). PUD and US identified ≥S1 according to CAP values respectively with Sn 0.87, Sp 0.61, PPV 0.49, NPV 0.91, LR+ 2.04, LR- 0.07, AUROC 0.74 and Sn 0.96, Sp 0.54, PPV 0.47, NPV 0.97, LR+ 2.10, LR- 0.07, AUROC 0.75.
CONCLUSIONS CONCLUSIONS
PUD shows good reproducibility and diagnostic accuracy in ruling liver steatosis out, representing a useful point-of-care tool to avail of hepatologists interested in excluding NAFLD, but with basic US skills.

Identifiants

pubmed: 38016894
pii: S1590-8658(23)01032-0
doi: 10.1016/j.dld.2023.11.014
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest The authors have declared no conflict of interest for this article.

Auteurs

Andrea Costantino (A)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Endoscopy Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Alessandra Piagnani (A)

Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Riccardo Caccia (R)

Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Andrea Sorge (A)

Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Marco Maggioni (M)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pathology Unit, Milan, Italy.

Riccardo Perbellini (R)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Hepatology Unit, Milan, Italy.

Francesca Donato (F)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Hepatology Unit, Milan, Italy.

Roberta D'Ambrosio (R)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Hepatology Unit, Milan, Italy.

Nicole Piazza O Sed (NPO)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Endoscopy Unit, Milan, Italy.

Luca Valenti (L)

Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Translational Medicine, Department of Transfusion Medicine and Hematology, Milan, Italy.

Daniele Prati (D)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Translational Medicine, Department of Transfusion Medicine and Hematology, Milan, Italy.

Maurizio Vecchi (M)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Endoscopy Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Pietro Lampertico (P)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Hepatology Unit, Milan, Italy; CRC "A. M. and A. Migliavacca" Center for Liver Disease, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Mirella Fraquelli (M)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Endoscopy Unit, Milan, Italy. Electronic address: mfraquelli@yahoo.it.

Classifications MeSH