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Inter-sonographer reproducibility of quantitative ultrasound outcomes and shear wave speed measured in the right lobe of the liver in adults with known or suspected non-alcoholic fatty liver disease
Authors:Aiguo?Han  Yassin?Labyed  Ethan?Z?Sy  Andrew?S?Boehringer  Michael?P?Andre  Jr" target="_blank">John?W?ErdmanJr  Rohit?Loomba  Claude?B?Sirlin  JrEmail author" target="_blank">William?D?O’BrienJrEmail author
Institution:1.Bioacoustics Research Laboratory, Department of Electrical and Computer Engineering,University of Illinois at Urbana-Champaign,Urbana,USA;2.Siemens Healthineers USA,Issaquah,USA;3.Liver Imaging Group, Department of Radiology,University of California at San Diego,La Jolla,USA;4.Department of Radiology,University of California at San Diego,San Diego,USA;5.San Diego VA Healthcare System,San Diego,USA;6.Department of Food Science and Human Nutrition,University of Illinois at Urbana-Champaign,Urbana,USA;7.NAFLD Research Center, Division of Gastroenterology, Department of Medicine,University of California at San Diego,La Jolla,USA
Abstract:

Objectives

To assess inter-sonographer reproducibility of ultrasound attenuation coefficient (AC), backscatter coefficient (BSC) and shear wave speed (SWS) in adults with known/suspected non-alcoholic fatty liver disease (NAFLD).

Methods

The institutional review board approved this HIPAA-compliant prospective study; informed consent was obtained. Participants with known/suspected NAFLD were recruited and underwent same-day liver examinations with a clinical scanner. Each participant was scanned by two of the six trained sonographers. Each sonographer performed multiple data acquisitions in the right liver lobe using a lateral intercostal approach. A data acquisition was a single operator button press that recorded a B-mode image, radio-frequency data, and the SWS value. AC and BSC were calculated from the radio-frequency data using the reference phantom method. SWS was calculated automatically using product software. Intraclass correlation coefficient (ICC) and within-subject coefficient of variation (wCV) were calculated for applicable metrics.

Results

Sixty-one participants were recruited. Inter-sonographer ICC was 0.86 (95% confidence interval: 0.77–0.92) for AC and 0.87 (0.78–0.92) for log-transformed BSC (logBSC?=?10log10BSC) using one acquisition per sonographer. ICC was 0.88 (0.80–0.93) for both AC and logBSC averaging 5 acquisitions. ICC for SWS was 0.57 (0.29–0.74) using one acquisition per sonographer, and 0.84 (0.66–0.93) using 10 acquisitions. The wCV was ~7% for AC, and 19–43% for SWS, depending on number of acquisitions.

Conclusions

Hepatic AC, BSC and SWS measures on a clinical scanner have good inter-sonographer reproducibility in adults with known or suspected NAFLD. Multiple acquisitions are required for SWS but not AC or BSC to achieve good inter-sonographer reproducibility.

Key Points

? AC, BSC and SWS measurements are reproducible in adults with NAFLD. ? Inter-sonographer reproducibility of SWS measurement improves with more acquisitions being averaged. ? Multiple acquisitions are required for SWS but not AC or BSC.
Keywords:
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