Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis.
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| Title: | Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis. |
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| Authors: | Pickhardt, Perry1, Park, Seong2 parksh.radiology@gmail.com, Hahn, Luke1, Lee, Sung-Gyu3, Bae, Kyongtae4, Yu, Eun5 |
| Source: | European Radiology. May2012, Vol. 22 Issue 5, p1075-1082. 8p. 1 Black and White Photograph, 1 Graph. |
| Subjects: | Fatty degeneration, Fatty liver, Liver biopsy, Tomography, Regression analysis |
| Geographic Terms: | United States |
| Abstract: | Objectives: To determine a highly specific liver attenuation threshold at unenhanced CT for biopsy-proven moderate to severe hepatic steatosis (≥30% at histology). Methods: 315 asymptomatic adults (mean age ± SD, 31.5 ± 10.1 years; 207 men, 108 women) underwent same-day unenhanced liver CT and ultrasound-guided liver biopsy. Blinded to biopsy results, CT liver attenuation was measured using standard region-of-interest methodology. Multiple linear regression analysis was used to assess the relationship of CT liver attenuation with patient age, gender, BMI, CT system, and hepatic fat and iron content. Results: Thirty-nine subjects had moderate to severe steatosis and 276 had mild or no steatosis. A liver attenuation threshold of 48 HU was 100% specific (276/276) for moderate to severe steatosis, with no false-positives. Sensitivity, PPV and NPV at this HU threshold was 53.8%, 100% and 93.9%. Hepatic fat content was the overwhelming determinant of liver attenuation values, but CT system ( P < 0.001), and hepatic iron ( P = 0.035) also had a statistically significant independent association. Conclusions: Unenhanced CT liver attenuation alone is highly specific for moderate to severe hepatic steatosis, allowing for confident non-invasive identification of large retrospective/prospective cohorts for natural history evaluation of incidental non-alcoholic fatty liver disease. Low sensitivity, however, precludes effective population screening at this threshold. Key Points: • Unenhanced CT liver attenuation is highly specific for diagnosing moderate/severe hepatic steatosis. • Unenhanced CT can identify large cohorts for epidemiological studies of incidental steatosis. • Unenhanced CT is not, however, effective for population screening for hepatic steatosis. [ABSTRACT FROM AUTHOR] |
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| Database: | Engineering Source |
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