Quantitative ultrasound-derived fat fraction for hepatic steatosis in MASLD using liver biopsy as the reference standard: a dual-center study.
Ultrasound fat fraction accurately detects mild hepatic steatosis versus biopsy in MASLD.
Quantitative ultrasound-derived fat fraction for hepatic steatosis in MASLD using liver biopsy as the reference standard: a dual-center study.
This study evaluated the performance of ultrasound-derived fat fraction (ultrasound-derived fat fraction) against histopathology for the grading of hepatic steatosis.
From August 2022 to September 2024, this prospective dual-center study enrolled 418 participants (376 from Center 1, 42 from Center 2) with confirmed or suspected MASLD, all of whom underwent ultrasound-derived fat fraction and liver biopsy.
excellent accuracy distinguishing steatosis from no steatosis, 1.0 is perfect
Ultrasound-derived fat fraction showed excellent reproducibility and strong correlations with histopathology (Spearman's ρ = 0.724-0.767, p < 0.001).
Bland-Altman analyses revealed minimal bias between ultrasound-derived fat fraction and histopathology (Center 1/2: 1.432%/1.921%).
In our biopsy-selected MASLD cohort, the optimal ultrasound-derived fat fraction cut-offs were ≥ 6%, ≥ 15%, and ≥ 21% for mild (S ≥ 1), moderate (S ≥ 2), and severe (S3) steatosis, respectively.
Ultrasound-derived fat fraction demonstrated promising performance for steatosis grading in patients with clinically indicated biopsy and might serve as a useful non-invasive tool.
KEY POINTS: Question Can ultrasound-derived fat fraction provide a reproducible, accurate, and clinically reliable imaging-based assessment of hepatic steatosis grading in MASLD?
Findings ultrasound-derived fat fraction accurately grades hepatic steatosis against histopathology.
Optimized cut-offs (≥ 6%/≥ 15%/≥ 21%) reduce indeterminate classifications by up to 24.6%, and high reproducibility enables robust multicenter application.