The ultrasound‐guided attenuation parameter is useful in quantification of hepatic steatosis in non‐alcoholic fatty liver disease

AIM: To determine the utility of the ultrasound‐guided attenuation parameter (UGAP) for quantifying hepatic steatosis in non‐alcoholic fatty liver disease (NAFLD). METHODS: Subjects were 84 patients with NAFLD (53 men, 31 women; mean age 54 [20–81] years) who underwent liver biopsy and ultrasonography using a GE LOGIQ E9 system and C1‐6 probe at our hospital between 2017 and 2020. B‐Mode imaging of segment V in the liver was acquired and echo attenuation was assessed using UGAP. Steatosis score (S0: <5%; S1: 5%–33%; S2: 34%–66%; S3: ≥67%) from liver specimens was compared with the attenuation coefficient (AC; dB/cm/MHz) using UGAP. RESULTS: Steatosis score was S0 for 9 patients, S1 for 40, S2 for 21, and S3 for 14. AC by steatosis score was 0.52 ± 0.07, 0.63 ± 0.07, 0.74 ± 0.06, and 0.78 ± 0.06 dB/cm/MHz for S0, S1, S2, and S3, respectively. AC by UGAP differed significantly between S0 and S1, S0 and S2, S0 and S3, S1 and S2, and S1 and S3 (all P < 0.01), demonstrating a significant increase with steatosis score. Receiver operating characteristic analysis showed good diagnostic performance of UGAP for patients with steatosis score ≥1, ≥2, and ≥3 (AUROC = 0.94, 0.95, and 0.88, respectively). Liver fat content (%) from liver specimens and AC (r = 0.81, P < 0.01) showed a significant positive correlation. CONCLUSION: UGAP is useful for quantifying hepatic steatosis in patients with NAFLD.