The following is a summary of “A Reappraisal of the Diagnostic Performance of B-Mode Ultrasonography for Mild Liver Steatosis,” published in the May 2023 issue of Gastroenterology by Lee, et al.

Previous studies have indicated that B-mode ultrasonography (B-USG) has high specificity (80%-100%) but low sensitivity (50%-70%) in diagnosing fatty liver disease, particularly for mild steatosis. For a study, researchers sought to reevaluate the diagnostic performance of B-USG for fatty liver disease.

The retrospective, multinational, multicenter, cross-sectional, observational study involved six referral centers from three nations. They included 5,056 participants who underwent both B-USG and magnetic resonance proton density fat fraction (MRI-PDFF) within a six-month period. The diagnostic performance of B-USG was compared to MRI-PDFF, which served as the reference standard for fatty liver diagnosis. Sensitivity, specificity, positive and negative predictive values, diagnostic accuracy, and the area under the receiver operating characteristic curve (AUC) were calculated.

For diagnosing mild liver steatosis (defined as 6.5% ≤ MRI-PDFF ≤ 14%), B-USG exhibited a sensitivity of 83.4%, specificity of 81.0%, and AUC of 0.822. In diagnosing fatty liver disease (MRI-PDFF ≥ 6.5%), B-USG had a sensitivity of 83.4%, specificity of 81.0%, and AUC of 0.822. The mean PDFF of B-USG-diagnosed nonfatty liver differed significantly from that of diagnosed mild liver steatosis (3.5% ± 2.8% vs. 8.5% ± 5.0%, P < 0.001). The interinstitutional variability of B-USG in diagnosing fatty liver was similar in diagnostic accuracy across the six centers (82.8% – 88.6%, P = 0.416).

B-USG was found to be an effective and objective method for detecting mild liver steatosis when compared to MRI-PDFF, irrespective of etiologies and comorbidities.

Source: journals.lww.com/ajg/Abstract/2023/05000/A_Reappraisal_of_the_Diagnostic_Performance_of.20.aspx