Ultrasonic Adaptive Sound Speed Estimation for the Diagnosis and Quantification of Hepatic Steatosis: A Pilot Study

2018 ◽  
Vol 40 (06) ◽  
pp. 722-733 ◽  
Author(s):  
Marco Dioguardi Burgio ◽  
Marion Imbault ◽  
Maxime Ronot ◽  
Alex Faccinetto ◽  
Bernard E. Van Beers ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Sound Speed ◽  
Validation Cohort ◽  
Liver Steatosis ◽  
Receiver Operating Curve ◽  
Coefficient Of Determination ◽  
Proton Density ◽  
Speed Estimation ◽  
Training Cohort ◽  
Receiver Operating Curve Analysis

Abstract Purpose To evaluate the ability of a new ultrasound (US) method based on sound speed estimation (SSE) with respect to the detection, quantification, and grading of hepatic steatosis using magnetic resonance (MR) proton density fat fraction (PDFF) as the reference standard and to calculate one US fat index based on the patient’s SSE. Materials and Methods This study received local IRB approval. Written informed consent was obtained from patients. We consecutively included N = 50 patients as the training cohort and a further N = 50 as the validation cohort who underwent both SSE and abdominal MR. Hepatic steatosis was classified according to MR-PDFF cutoffs as: S0 ≤ 6.5 %, S1 6.5 to 16.5 %, S2 16.5 to 22 %, S3 ≥ 22 %. Receiver operating curve analysis was performed to evaluate the diagnostic performance of SSE in the diagnosis of steatosis (S1–S3). Based on the optimal data fit derived from our study, we proposed a correspondence between the MR-PDFF and a US fat index. Coefficient of determination R2 was used to evaluate fit quality and was considered robust when R2 > 0.6. Results The training and validation cohorts presented mean SSE values of 1.570 ± 0.026 and 1.568 ± 0.023 mm/µs for S0 and 1.521 ± 0.031 and 1.514 ± 0.019 mm/µs for S1–S3 (p < 0.01) patients, respectively. An SSE threshold of ≤ 1.537 mm/µs had a sensitivity of 80 % and a specificity of 85.7 % in the diagnosis of steatosis (S1-S3) in the training cohort. Robust correspondence between MR-PDFF and the US fat index was found both for the training (R2 = 0.73) and the validation cohort (R2 = 0.76). Conclusion SSE can be used to detect, quantify and grade liver steatosis and to calculate a US fat index.

scholarly journals Uncovering the invisible—prevalence, characteristics, and radiomics feature–based detection of visually undetectable intraprostatic tumor lesions in 68GaPSMA-11 PET images of patients with primary prostate cancer

2020 ◽  
Author(s):  
Constantinos Zamboglou ◽  
Alisa S. Bettermann ◽  
Christian Gratzke ◽  
Michael Mix ◽  
Juri Ruf ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Validation Cohort ◽  
External Validation ◽  
Image Interpretation ◽  
Receiver Operating Curve ◽  
Training Cohort ◽  
Primary Prostate Cancer ◽  
Psma Pet ◽  
Number Of Patients ◽  
Clinically Significant

Abstract Introduction Primary prostate cancer (PCa) can be visualized on prostate-specific membrane antigen positron emission tomography (PSMA-PET) with high accuracy. However, intraprostatic lesions may be missed by visual PSMA-PET interpretation. In this work, we quantified and characterized the intraprostatic lesions which have been missed by visual PSMA-PET image interpretation. In addition, we investigated whether PSMA-PET-derived radiomics features (RFs) could detect these lesions. Methodology This study consists of two cohorts of primary PCa patients: a prospective training cohort (n = 20) and an external validation cohort (n = 52). All patients underwent 68Ga-PSMA-11 PET/CT and histology sections were obtained after surgery. PCa lesions missed by visual PET image interpretation were counted and their International Society of Urological Pathology score (ISUP) was obtained. Finally, 154 RFs were derived from the PET images and the discriminative power to differentiate between prostates with or without visually undetectable lesions was assessed and areas under the receiver-operating curve (ROC-AUC) as well as sensitivities/specificities were calculated. Results In the training cohort, visual PET image interpretation missed 134 tumor lesions in 60% (12/20) of the patients, and of these patients, 75% had clinically significant (ISUP > 1) PCa. The median diameter of the missed lesions was 2.2 mm (range: 1–6). Standard clinical parameters like the NCCN risk group were equally distributed between patients with and without visually missed lesions (p < 0.05). Two RFs (local binary pattern (LBP) size-zone non-uniformality normalized and LBP small-area emphasis) were found to perform excellently in visually unknown PCa detection (Mann-Whitney U: p < 0.01, ROC-AUC: ≥ 0.93). In the validation cohort, PCa was missed in 50% (26/52) of the patients and 77% of these patients possessed clinically significant PCa. The sensitivities of both RFs in the validation cohort were ≥ 0.8. Conclusion Visual PSMA-PET image interpretation may miss small but clinically significant PCa in a relevant number of patients and RFs can be implemented to uncover them. This could be used for guiding personalized treatments.

scholarly journals Diagnostic Value of MRI Proton Density Fat Fraction for Assessing Liver Steatosis in Chronic Viral C Hepatitis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Francesco Paparo ◽  
Giovanni Cenderello ◽  
Matteo Revelli ◽  
Lorenzo Bacigalupo ◽  
Mariangela Rutigliani ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Diagnostic Accuracy ◽  
Hepatic Steatosis ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Diagnostic Value ◽  
Proton Density ◽  
Time Interval ◽  
Fat Fraction

Objective.To assess the diagnostic performance of a T1-independent, T2*-corrected multiecho magnetic resonance imaging (MRI) technique for the quantification of hepatic steatosis in a cohort of patients affected by chronic viral C hepatitis, using liver biopsy as gold standard.Methods.Eighty-one untreated patients with chronic viral C hepatitis were prospectively enrolled. All included patients underwent MRI, transient elastography, and liver biopsy within a time interval <10 days.Results.Our cohort of 77 patients included 43/77 (55.8%) males and 34/77 (44.2%) females with a mean age of 51.31 ± 11.27 (18–81) years. The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r=0.754, 95% CI 0.637 to 0.836,P<0.0001), and the correlation was influenced by neither the liver stiffness nor the T2*decay. The median MRI PDFF result was significantly lower in the F4 subgroup (P<0.05). The diagnostic accuracy of MRI PDFF evaluated by AUC-ROC analysis was 0.926 (95% CI 0.843 to 0.973) forS≥1and 0.929 (95% CI 0.847 to 0.975) forS=2.Conclusions.Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis.

scholarly journals Robust sound speed estimation for ultrasound-based hepatic steatosis assessment

2017 ◽  
Vol 62 (9) ◽  
pp. 3582-3598 ◽  
Author(s):  
Marion Imbault ◽  
Alex Faccinetto ◽  
Bruno-Félix Osmanski ◽  
Antoine Tissier ◽  
Thomas Deffieux ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Sound Speed ◽  
Speed Estimation

Non-Invasive Assessment of Liver Steatosis: A Comprehensive Comparison of Biomarkers- and Ultrasound-Based Techniques

2021 ◽  
Author(s):  
Katarzyna Kozlowska-Petriczko ◽  
Ewa Wunsch ◽  
Jan Petriczko ◽  
Wing-Kin Syn ◽  
Piotr Milkiewicz
Keyword(s):  
Diagnostic Accuracy ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Sensitivity And Specificity ◽  
Practical Importance ◽  
Liver Steatosis ◽  
Receiver Operating Curve ◽  
Routine Practice ◽  
Alcoholic Fatty Liver ◽  
Non Invasive

Abstract Background & Aims: In view of limited reliability of the biopsy in the assessment of liver fat, a non-invasive, trustworthy and more accessible method estimating a degree of steatosis is urgently needed. While controlled attenuation parameter (CAP) is used to quantify hepatic fat, its availability in routine practice is limited. Therefore, the aim of this study was to compare the diagnostic accuracy of biomarker- and ultrasound-based techniques for the diagnosis and grading of hepatic steatosis. Methods: This was a prospective study of 167 adults with and without non-alcoholic fatty liver disease. As measured against CAP, we assessed Hamaguchi’s score and the hepatorenal index (HRI), and the following biochemical measures: the fatty liver index, hepatic steatosis index and lipid accumulation product scores during a single out-patient visit. Area under the receiver operating curve (AUROC) analyses were used to evaluate the diagnostic accuracy of each test and to calculate optimal thresholds for the ultrasound techniques. Results: All non-invasive methods displayed high accuracy in detecting steatosis (mean AUC value ≥ 0.90), with Hamaguchi’s score and the HRI as the most precise. These two tests also had the highest sensitivity and specificity (82.2% and 100%; 86.9% and 94.8%, respectively). We propose new thresholds for Hamaguchi’s score and HRI for hepatic steatosis grading, indicated by optimal sensitivity and specificity. Conclusion: Ultrasound-based techniques are the most accurate for assessing liver steatosis compared to other non-invasive tests. Given the accessibility of ultrasonography, this finding is of practical importance for the assessment of liver steatosis in clinical settings.

scholarly journals Diagnostic Accuracy of Non-Imaging and Ultrasound-Based Assessment of Hepatic Steatosis Using Controlled Attenuation Parameter (CAP) as Reference

2021 ◽  
Vol 10 (7) ◽  
pp. 1507
Author(s):  
Katarzyna Kozłowska-Petriczko ◽  
Ewa Wunsch ◽  
Jan Petriczko ◽  
Wing-Kin Syn ◽  
Piotr Milkiewicz
Keyword(s):  
Diagnostic Accuracy ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Sensitivity And Specificity ◽  
Liver Steatosis ◽  
Receiver Operating Curve ◽  
Controlled Attenuation Parameter ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Attenuation Parameter

Background & Aims: In view of the limited reliability of biopsies in the assessment of liver fat, a non-invasive, trustworthy, and more accessible method estimating a degree of steatosis is urgently needed. While the controlled attenuation parameter (CAP) is used to quantify hepatic fat, its availability in routine practice is limited. Therefore, the aim of this study was to compare the diagnostic accuracy of biomarker- and ultrasound-based techniques for the diagnosis and grading of hepatic steatosis. Methods: This was a prospective study of 167 adults with and without non-alcoholic fatty liver disease. As measured against CAP, we assessed Hamaguchi’s score and the hepatorenal index (HRI), and the following biochemical measures: the fatty liver index, hepatic steatosis index, and lipid accumulation product scores during a single out-patient visit. Area under the receiver operating curve (AUROC) analyses were used to evaluate the diagnostic accuracy of each test and to calculate optimal thresholds for the ultrasound techniques. Results: All non-invasive methods displayed high accuracy in detecting steatosis (mean AUC value ≥ 0.90), with Hamaguchi’s score and the HRI being the most precise. These two tests also had the highest sensitivity and specificity (82.2% and 100%; 86.9% and 94.8%, respectively). We propose new thresholds for Hamaguchi’s score and HRI for hepatic steatosis grading, indicated by optimal sensitivity and specificity. Conclusions: Ultrasound-based techniques are the most accurate for assessing liver steatosis compared to other non-invasive tests. Given the accessibility of ultrasonography, this finding is of practical importance for the assessment of liver steatosis in clinical settings.

Pharmacogenetic algorithm for predicting daily dose of warfarin in Caucasian patients of Czech origin

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Aleš Tomek ◽  
Tereza Růžičková ◽  
Vojtěch Kaplan ◽  
Zuzana Lacinová ◽  
Simona Kumstýřová ◽  
...  
Keyword(s):  
Validation Cohort ◽  
Warfarin Dose ◽  
Therapeutic Index ◽  
Coefficient Of Determination ◽  
Dose Prediction ◽  
Pharmacogenetic Algorithm ◽  
Daily Dose ◽  
Caucasian Patients ◽  
Variant Alleles ◽  
Initiation Of Therapy

Abstract Objectives Warfarin use is limited by a low therapeutic index and significant interindividual variability of the daily dose. The most important factor predicting daily warfarin dose is individual genotype, polymorphisms of genes CYP2C9 (warfarin metabolism) and VKORC1 (sensitivity for warfarin). Algorithms using clinical and genetic variables could predict the daily dose before the initiation of therapy. The aim of this study was to develop and validate an algorithm for the prediction of warfarin daily dose in Czech patients. Methods Detailed clinical data of patients with known and stable warfarin daily dose were collected. All patients were genotyped for polymorphisms in genes CYP2C9 and VKORC1. Results Included patients were divided into derivation (n=175) and validation (n=223) cohorts. The final algorithm includes the following variables: Age, height, weight, treatment with amiodarone and presence of variant alleles of genes CYP2C9 and VKORC1. The adjusted coefficient of determination is 72.4% in the derivation and 62.3% in the validation cohort (p<0.001). Conclusions Our validated algorithm for warfarin daily dose prediction in our Czech cohort had higher precision than other currently published algorithms. Pharmacogenetics of warfarin has the potential in the clinical practice in specialized centers.

scholarly journals Albumin platelet product as a novel score for liver fibrosis stage and prognosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Koji Fujita ◽  
Kazumi Yamasaki ◽  
Asahiro Morishita ◽  
Tingting Shi ◽  
Joji Tani ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Validation Cohort ◽  
Activity Grade ◽  
Fibrosis Stage ◽  
Strongly Correlated ◽  
The Novel ◽  
Training Cohort ◽  
Blood Examination ◽  
Retrospective Multicenter Study ◽  
Overall Mortality

AbstractFibrosis-4 index, a conventional biomarker for liver fibrosis stage, is confounded by age and hepatitis activity grade. The current retrospective multicenter study aimed to formulate the novel indices of liver fibrosis by mathematically combining items of peripheral blood examination and to evaluate ability of prognosis prediction. After a novel index was established in a training cohort, the index was tested in a validation cohort. Briefly, a total of 426 patients were enrolled in a training cohort. Albumin and platelet most strongly correlated to fibrosis stage among blood examination. Albumin platelet product (APP) = Albumin × platelet/1000 could differentiate the four stages of liver fibrosis (p < 0.05). APP indicated fibrosis stage independent from hepatitis activity grade. A cut-off value = 4.349 diagnosed cirrhosis with area under ROC more than 0.8. Multivariate analysis revealed that smaller APP independently contributed to HCC prevalence and overall mortality. The results were validated in another 707 patients with HCV infection. In conclusion, APP was not confounded by age or hepatitis activity grade contrary to Fibrosis-4 index. APP is as simple as physicians can calculate it by pen calculation. The product serves physicians in managing patients with chronic liver disease.

scholarly journals Depdc5 deficiency exacerbates alcohol-induced hepatic steatosis via suppression of PPARα pathway

2021 ◽  
Vol 12 (7) ◽  
Author(s):  
Lin Xu ◽  
Xinge Zhang ◽  
Yue Xin ◽  
Jie Ma ◽  
Chenyan Yang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Hepatic Steatosis ◽  
Liver Steatosis ◽  
Pharmacological Intervention ◽  
Acid Oxidation ◽  
Peroxisome Proliferator ◽  
Pathological Effect ◽  
Mtorc1 Pathway

AbstractAlcohol-related liver disease (ALD), a condition caused by alcohol overconsumption, occurs in three stages of liver injury including steatosis, hepatitis, and cirrhosis. DEP domain-containing protein 5 (DEPDC5), a component of GAP activities towards Rags 1 (GATOR1) complex, is a repressor of amino acid-sensing branch of the mammalian target of rapamycin complex 1 (mTORC1) pathway. In the current study, we found that aberrant activation of mTORC1 was likely attributed to the reduction of DEPDC5 in the livers of ethanol-fed mice or ALD patients. To further define the in vivo role of DEPDC5 in ALD development, we generated Depdc5 hepatocyte-specific knockout mouse model (Depdc5-LKO) in which mTORC1 pathway was constitutively activated through loss of the inhibitory effect of GATOR1. Hepatic Depdc5 ablation leads to mild hepatomegaly and liver injury and protects against diet-induced liver steatosis. In contrast, ethanol-fed Depdc5-LKO mice developed severe hepatic steatosis and inflammation. Pharmacological intervention with Torin 1 suppressed mTORC1 activity and remarkably ameliorated ethanol-induced hepatic steatosis and inflammation in both control and Depdc5-LKO mice. The pathological effect of sustained mTORC1 activity in ALD may be attributed to the suppression of peroxisome proliferator activated receptor α (PPARα), the master regulator of fatty acid oxidation in hepatocytes, because fenofibrate (PPARα agonist) treatment reverses ethanol-induced liver steatosis and inflammation in Depdc5-LKO mice. These findings provide novel insights into the in vivo role of hepatic DEPDC5 in the development of ALD.

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