A new visual quantitative assessment of ultrasound attenuation parameters for the mild liver steatosis

BACKGROUND: Controlled attenuation parameter (CAP) without the guidance of the grey scale sonogram was a classic method in the quantitative evaluation of liver steatosis, it is recommended by international guidelines. Our study aimed to compare the diagnostic efficiency of a new real-time visual liver steatosis analysis (LiSA) versus CAP in chronic hepatitis B patients with liver steatosis. METHODS: Patients were enrolled who underwent liver biopsy and received both LiSA (Hepatus, Mindray, probe LFP5-1U/s, China) and CAP (FibroScan502, Echosens, probe M, France) measurement simultaneously in our hospital from November 2018 to December 2019. The obtained values were both expressed as dB/m. Based on the liver fat content validated by liver biopsy, these patients were divided into the S0 group (fat content <5%) and S1 group (fat content ≥5%). The efficiency of the LiSA and CAP value in the diagnosis of liver steatosis was evaluated. Independent factors influencing the LiSA value were predicted by correlation analysis and multiple linear regression analysis. RESULTS: A total of 151 patients were included in the analysis according to the exclusion criteria from 304 enrolled liver biopsy chronic hepatitis B (CHB) patients. Both LiSA and CAP successfully differentiated the S0 group from the S1 group. Receiver operating characteristic (ROC) curves showed that both LiSA and CAP had good diagnostic performance [area under the ROC curve area under the curve (AUC) >0.7] in evaluating liver steatosis, while there was no significant difference between the 2 methods (AUC 0.825 vs. 0.798, P=0.067). Using the optimal cutoff point, the specificity and sensitivity of LiSA in diagnosing liver steatosis were 89.18% and 79.16%, respectively. The specificity and sensitivity of CAP in diagnosing liver steatosis were 87.20% and 76.31%, respectively. CONCLUSIONS: Both LiSA and CAP are efficient for evaluating liver steatosis noninvasively.