Accuracy of Controlled Attenuation Parameter for Liver Steatosis in High-Risk Patients for MASLD Using MRI-Proton Density Fat Fraction as Reference Standard

期刊论文
发表日期：

2024年12月21日

查看全文

Konstantinos Malandris,
Emmanouil Korakas,
Anna Sarakapina,
Georgios Kalopitas,
Fotini Iatridi,
Aris Liakos,
Eleni Bekiari,
Olga Giouleme,
Glykeria Tzatzagou,
Thomas Karagiannis,
Paschalis Paschos,
Despoina Vasilakou,
Vaia Lambadiari,
Elli Tzamou,
Dimitrios Daravigkas,
Emmanouil Sinakos,
Apostolos Tsapas

摘要

Aim

Controlled attenuation parameter (CAP) enables the noninvasive diagnosis of liver steatosis. Magnetic resonance imaging proton density fat fraction (MRI-PDFF) is increasingly used over biopsy for the assessment of steatosis in patients at risk for metabolic dysfunction-associated steatotic liver disease (MASLD). We assessed the accuracy of CAP for liver steatosis defined as MRI-PDFF ≥ 5%.

Methods

We performed a cross-sectional, diagnostic accuracy study. We prospectively recruited consecutive adult participants with type 2 diabetes and body mass index (BMI) ≥ 25 kg/m², who underwent CAP and MRI-PDFF within two weeks.

Results

We included 113 participants. The area under the receiver operating characteristic (AUROC) of CAP for MRI-PDFF ≥ 5% was 0.82 [95% confidence interval (CI) 0.74–0.89]. CAP thresholds for ruling-out (sensitivity > 90%) and ruling-in (specificity > 90%) liver steatosis were below 249 and over 328 dB/m respectively. The AUROC of CAP for the detection of MRI-PDFF ≥ 10% was 0.81 (0.73–0.88). CAP thresholds for ruling-out and ruling-in MRI-PDFF ≥ 10% were below 271 and over 345 dB/m respectively. CAP measurements with an interquartile range (IQR) < 30 dB/m improved the detection of higher steatosis grades.

Conclusion

CAP has acceptable accuracy for diagnosing MRI-PDFF defined steatosis. Values below 249 dB/m can be used to rule-out liver steatosis, while values over 328 dB/m can set the diagnosis. An IQR < 30 dB/m might improve the accuracy of CAP for higher steatosis grades.

Clinical trial registration: Not applicable.