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Background <p>Metabolic dysfunction-associated steatotic liver disease is increasingly affecting younger populations. Ultrasound-derived fat fraction is a technique used in ultrasound to quantify liver fat content. The diagnostic performance of ultrasound-derived fat fraction in pediatric patients with metabolic dysfunction-associated steatotic liver disease is yet to be evaluated.</p> Objective <p>To evaluate the diagnostic performance of ultrasound-derived fat fraction measurement in detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease.</p> Materials and methods <p>In this prospective study, pediatric patients diagnosed with metabolic dysfunction-associated steatotic liver disease were enrolled. Six acquisitions of ultrasound-derived fat fraction were obtained. Taking magnetic resonance imaging (MRI)-proton density fat fraction as a reference standard, the area under the receiver operating characteristic curve (AUC) was performed to evaluate the diagnostic performance of ultrasound-derived fat fraction. Youden index was used to determine the cutoff value of ultrasound-derived fat fraction. Correlation coefficient and Bland–Altman plot were performed.</p> Results <p>From April 2024 to March 2025, 32 patients (median age, 12&#xa0;years; median body mass index, 29.7&#xa0;kg/m<sup>2</sup>) were included. The ultrasound-derived fat fraction values showed a positive correlation with MRI-proton density fat fraction (<i>r</i> = 0.72). The ultrasound-derived fat fraction values and MRI-proton density fat fraction had a mean bias of 3.3% (95% limits of agreement: -16.4, 23.1). Using MRI-proton density fat fractions ≥ 5%, ≥ 15%, and ≥ 25% as the reference standard for diagnosing hepatic steatosis grade ≥ S1, ≥ S2, and S3, the AUCs of ultrasound-derived fat fraction were 0.84, 0.88, and 0.88, with the cutoff values of 9.5%, 10.5%, and 12.8%, respectively.</p> Conclusion <p>Ultrasound-derived fat fraction demonstrates promising diagnostic performance for detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease within this cohort.</p> Graphical Abstract <p></p>

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Quantitative ultrasound-derived fat fraction for identifying pediatric patients with metabolic dysfunction-associated steatotic liver disease: a prospective study

  • 期刊论文

  • 发表日期：

    2025年8月1日

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  • Yunlin Huang,
  • Chao Sun,
  • Juan Cheng,
  • Ying Wang,
  • Yijie Qiu,
  • Shiwen Wang,
  • Ming Wang,
  • Li Wei,
  • Rui Cheng,
  • Jian-Gao Fan,
  • Yi Dong

摘要

Background

Metabolic dysfunction-associated steatotic liver disease is increasingly affecting younger populations. Ultrasound-derived fat fraction is a technique used in ultrasound to quantify liver fat content. The diagnostic performance of ultrasound-derived fat fraction in pediatric patients with metabolic dysfunction-associated steatotic liver disease is yet to be evaluated.

Objective

To evaluate the diagnostic performance of ultrasound-derived fat fraction measurement in detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease.

Materials and methods

In this prospective study, pediatric patients diagnosed with metabolic dysfunction-associated steatotic liver disease were enrolled. Six acquisitions of ultrasound-derived fat fraction were obtained. Taking magnetic resonance imaging (MRI)-proton density fat fraction as a reference standard, the area under the receiver operating characteristic curve (AUC) was performed to evaluate the diagnostic performance of ultrasound-derived fat fraction. Youden index was used to determine the cutoff value of ultrasound-derived fat fraction. Correlation coefficient and Bland–Altman plot were performed.

Results

From April 2024 to March 2025, 32 patients (median age, 12 years; median body mass index, 29.7 kg/m2) were included. The ultrasound-derived fat fraction values showed a positive correlation with MRI-proton density fat fraction (r = 0.72). The ultrasound-derived fat fraction values and MRI-proton density fat fraction had a mean bias of 3.3% (95% limits of agreement: -16.4, 23.1). Using MRI-proton density fat fractions ≥ 5%, ≥ 15%, and ≥ 25% as the reference standard for diagnosing hepatic steatosis grade ≥ S1, ≥ S2, and S3, the AUCs of ultrasound-derived fat fraction were 0.84, 0.88, and 0.88, with the cutoff values of 9.5%, 10.5%, and 12.8%, respectively.

Conclusion

Ultrasound-derived fat fraction demonstrates promising diagnostic performance for detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease within this cohort.

Graphical Abstract