ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
This article is part of the Research TopicDigital Technologies in Hepatology: Diagnosis, Treatment, and Epidemiological InsightsView all 20 articles
Accuracy of attenuation coefficient measurement (ACM) for hepatic steatosis: comparison with MRI proton density fat fraction (MRI-PDFF) and chemical fat analysis using multimodal liver fat phantoms
Provisionally accepted
- 1P. L. Shupyk National University of Health Care of Ukraine, Kyiv, Ukraine
- 2“Institute of Elastography” Medical Center LLC, Kyiv, Ukraine
- 3“Lifescan clinic”, Kyiv, Ukraine
- 4Natsional'nii universitet kharchovikh tekhnologii, Kyiv, Ukraine
- 5Nacional'nij medicnij universitet imeni O O Bohomol'ca, Kyiv, Ukraine
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Background. The objective of this study was to evaluate the accuracy and reproducibility of real-time ultrasound steatometry using attenuation coefficient measurement (ACM) in comparison with magnetic resonance imaging proton density fat fraction (MRI-PDFF) and chemical fat analysis. Specifically, we assessed the diagnostic performance and reproducibility of ultrasound-based ACM against MRI-PDFF and laboratory fat quantification using multimodal liver fat phantoms (LFPs) with varying fat-to-water ratios. Methods. Sixty LFPs with different fat concentrations were examined in two radiology centers and one chemical laboratory. Each phantom underwent three assessments: MRI-PDFF, ultrasound ACM, and laboratory-based chemical fat quantification. Correlation coefficients, intraclass correlation coefficients (ICC), receiver operating characteristic (ROC) analyses, and Bland–Altman analysis were performed to evaluate the relationships and agreement among the measurement methods. Results. Median values of ACM, MRI-PDFF, and laboratory fat content were 2.39 (1.87–2.84), 3.88 (2.46–7.60), and 1.24 (0.51–3.90), respectively. Strong correlations were observed between ACM and laboratory fat quantification (r = 0.878, p < 0.001) and between MRI-PDFF and laboratory analysis (r = 0.881, p < 0.001). ACM also correlated strongly with MRI-PDFF (r = 0.846, p < 0.001). The intraobserver reproducibility of ACM was excellent (ICC = 0.956, p < 0.001). AUROC values were 0.984 for ACM and 0.996 for MRI-PDFF, both indicating high diagnostic sensitivity and specificity. Conclusions. ACM demonstrated strong agreement with MRI-PDFF and chemical fat analysis in LFPs, supporting its potential as a reliable, accurate, and cost-effective noninvasive technique for hepatic steatosis quantification.
Keywords: ultrasound, Phantom, steatosis, MRI-PDFF, Attenuation coefficient measurement (ACM)
Received: 04 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Zhaivoronok, Dynnyk, Deresh, Nosenko and Kobyliak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Maksym Zhaivoronok, zhayvoronok.m@ukr.net
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