Staging hepatic steatosis in nonalcoholic fatty liver disease by quantitative conventional ultrasound imaging, validated with histopathology

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder in developed countries with a global prevalence of approximately 25%. NAFLD represents a spectrum of disorders and starts with benign steatosis (NAFL, ≥5% hepatic steatosis (HS)), but may lead to nonalcoholic steatohepatitis (NASH), inflammation with hepatocyte injury with or without fibrosis, which may lead to cirrhosis. Qualitative scoring of liver biopsies still is the gold standard for staging steatosis however, they are invasive and complications such as bleeding and infection may occur. For this reason we developed and tested a computer aided ultrasound (CAUS) protocol for the non-invasive assessment of liver HS using quantitative ultrasound (QUS) B-mode images. CAUS showed to have high predictive values (area under the curve (AUC) up to 0.95) in cows and similar correlations value with HS in a human pilot study. The current study was conducted in order to assess the predictive values of CAUS in staging hepatic steatosis in-vivo.