Inter-platform reproducibility of ultrasound-based fat fraction for evaluating hepatic steatosis in nonalcoholic fatty liver disease

Objectives

To evaluate the inter-platform reproducibility of ultrasound-based fat fraction examination in nonalcoholic fatty liver disease (NAFLD).

Methods

Patients suspected of having NAFLD were prospectively enrolled from January 2023. Ultrasound-based fat fraction examinations were performed using two different platforms (ultrasound-derived fat fraction [UDFF] and quantitative ultrasound-derived estimated fat fraction [USFF]) on the same day. The correlation between UDFF and USFF was assessed using Pearson correlation coefficient. Intraclass correlation coefficient (ICC), Bland–Altman analysis with 95% limits of agreement (LOAs), and the coefficient of variation (CV) were used to assess inter-platform reproducibility.

Results

A total of 41 patients (21 men and 20 women; mean age, 53.9 ± 12.6 years) were analyzed. Moderate correlation was observed between UDFF and USFF (Pearson’s r = 0.748; 95% confidence interval [CI]: 0.572–0.858). On Bland–Altman analysis, the mean difference between UDFF and USFF values was 1.3% with 95% LOAs ranging from -8.0 to 10.6%. The ICC between UDFF and USFF was 0.842 (95% CI: 0.703–0.916), with a CV of 29.9%.

Conclusion

Substantial inter-platform variability was observed among different ultrasound-based fat fraction examinations. Therefore, it is not appropriate to use ultrasound-based fat fraction values obtained from different vendors interchangeably.

Critical relevance statement

Considering the substantial inter-platform variability in ultrasound-based fat fraction assessments, caution is imperative when interpreting and comparing fat fraction values obtained from different ultrasound platforms in clinical practice.

Key points

• Inter-platform reproducibility of ultrasound-based fat fraction examinations is important for its clinical application.

• Significant variability across different ultrasound-based fat fraction examinations was observed.

• Using ultrasound-based fat fraction values from different vendors interchangeably is not advisable.

Graphical Abstract