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Prospective, Same-Day, Direct Comparison of Controlled Attenuation Parameter With the M vs the XL Probe in Patients With Nonalcoholic Fatty Liver Disease, Using Magnetic Resonance Imaging-Proton Density Fat Fraction as the Standard.

Authors
  • Caussy, Cyrielle1
  • Brissot, Justine2
  • Singh, Seema2
  • Bassirian, Shirin2
  • Hernandez, Carolyn2
  • Bettencourt, Ricki2
  • Rizo, Emily2
  • Richards, Lisa2
  • Sirlin, Claude B3
  • Loomba, Rohit4
  • 1 NAFLD Research Center, Department of Medicine, University of California, San Diego, La Jolla, California; CarMen Laboratory, INSERM U1060, INRA U1397, Université Claude Bernard Lyon 1, National Institute of Applied Sciences of Lyon, Pierre-Bénite, France; Département Endocrinologie, Diabète et Nutrition, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France. , (France)
  • 2 NAFLD Research Center, Department of Medicine, University of California, San Diego, La Jolla, California.
  • 3 Liver Imaging Group, Department of Radiology, University of California, San Diego, La Jolla, California.
  • 4 NAFLD Research Center, Department of Medicine, University of California, San Diego, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, California; Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California. Electronic address: [email protected]
Type
Published Article
Journal
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
Publication Date
Jul 01, 2020
Volume
18
Issue
8
Identifiers
DOI: 10.1016/j.cgh.2019.11.060
PMID: 31843596
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Controlled attenuation parameter (CAP) measurements using M probe have been reported to be lower than those of the XL-probe in detection of hepatic steatosis. However, there has been no direct comparison of CAP with the M vs the XL probe in patients with nonalcoholic fatty liver disease (NAFLD). We compared CAP with the M vs the XL probe for quantification of hepatic fat content, using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the standard. We performed a prospective study of 100 adults (mean body mass index [BMI], 30.6 ± 4.7 kg/m2) with and without NAFLD, assessed by CAP with the M probe and XL probe on the same day, at a single research center, from November 2017 through November 2018. We then measured the MRI-PDFF as the reference standard. Outcomes were presence of hepatic steatosis, defined as MRI-PDFF ≥ 5%, and detection of hepatic fat content ≥ 10%, defined as MRI-PDFF ≥ 10%. We performed area under the receiver operating characteristic curve (AUROC) analyses to assess the diagnostic accuracy of CAP for each probe in detection of hepatic steatosis (MRI-PDFF ≥ 5%) and of hepatic fat content ≥ 10%. Of the study participants, 68% had an MRI-PDFF of 5% or more and 48% had an MRI-PDFF of 10% or more. The mean CAP measured by the M probe (310 ± 62 db/m) was significantly lower than by the X probe (317 ± 63 db/m) (P = .007). When M probe was used in participants with BMIs <30 kg/m2 and XL probe in participants with BMIs ≥30 kg/m2, the CAP measured by the M probe (312 ± 51.4 db/m) remained significantly lower than that of the XL probe (345 ± 47.6 db/m) (P = .0035.), when the MRI-PDFF was above 5%. The optimal threshold of CAP for the detection of MRI-PDFF≥5%, was 294 db/m with the M probe and 307 db/m with the XL probe. The optimal threshold of CAP for the detection of MRI-PDFF ≥ 10%, was 311 db/m with the M probe and 322 db/m with the XL probe. For only the XL probe, CAP measurements with an interquartile range below 30 dB/m detected an MRI-PDFF≥5% with a lower AUROC (0.97; 95% CI, 0.80-1.00) than CAP measurements with an interquartile range above 30 dB/m (AUROC, 0.82; 95% CI, 0.71-0.90) (P = .0129). In an analysis of the same patients using CAP with the M probe and XL probe, with MRI-PDFF as the standard, we found that the M probe under-quantifies CAP values compared with the XL probe, independent of BMI. The type of probe should be considered when interpreting CAP data from patients with NAFLD. Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.

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