Society for Surgery of the Alimentary Tract
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Anca A. Plopeanu*1,2, Alina Popescu1,2, Radu Cotrau1,2, Renata Fofiu1,2, Adrian Burdan1,2, Darius Heredea1,2, Camelia G. Foncea1,2, Felix Bende1,2, Roxana Sirli1,2, Ioan Sporea1,2
1Department of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Timis, Romania; 2Center for Advanced Hepatology Research of the Academy of Medical Sciences, Timisoara, Romania

The aim of our study was to evaluate the feasibility of two new quantitative ultrasound (QUS) parameters, TSI (tissue scatter-distribution imaging) and TAI (tissue attenuation imaging) for the rule in of steatosis in patients with ALD considering CAP as reference.

Methods: A prospective study was conducted in which liver steatosis was assessed in 50 patients with ALD (92% males, mean age 58.45), evaluated in the same session by QUS and CAP implemented on the following systems: Samsung Medison RS85 (CA1-7A probe) and FibroScan Compact M 530, respectively. For CAP, reliable measurements were defined as the median value of 10 measurements with IQR/M<0.3. For QUS, five consecutive measurements of TAI and TSI were acquired by a color-coded map overlaid on B-mode ultrasound. Reliable measurements were defined as, R2 over 0.6. The cut-off value of 260 dB/m by CAP was considered as indicative for at least significant steatosis (S2–S3).

Results: Moderate correlations between steatosis assessment methods were observed: TAI vs. CAP, r=0.75, TSI vs. CAP, r=0.31, TSI vs. TAI, r=0.47. The best TAI rule-in and rule-out cut-off values to identify at least significant steatosis (S2–S3) were: >0.76 (AUROC=0.86, p<0.0001, PPV=94.1%, NPV=33.3%) for rule-in, and <0.55 (AUROC=0.86, p<0.0001, PPV=82.2%, NPV=80.1%) for rule-out, respectively. The best TSI rule-in and rule-out cut-off values for identifying significant steatosis were: >102.8 (AUROC=0.70, p<0.0001 PPV=92.9%, NPV=31.4%) for rule-in and <91.3 (AUROC=0.70, p<0.0001, PPV=75.6%, NPV=25.1%) for rule-out, respectively.

Conclusion: QUS measurements TAI/TSI are feasible methods for rule-in/ rule-out at of significant steatosis in ALD.

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