Introduction: Non-invasive assessment of steatosis and fibrosis is of growing relevance in non-alcoholic fatty liver disease
(NAFLD). 1H-Magnetic resonance spectroscopy (1H-MRS) and the ultrasound-based controlled attenuation parameter (CAP)
correlate with biopsy proven steatosis, but have not been correlated with each other so far. We therefore performed a headto-
head comparison between both methods.
Methods: Fifty patients with biopsy-proven NAFLD and 15 healthy volunteers were evaluated with 1H-MRS and transient
elastography (TE) including CAP. Steatosis was defined according to the percentage of affected hepatocytes: S1 5-33%, S2
34–66%, S3 $67%.
Results: Steatosis grade in patients with NAFLD was S1 36%, S2 40% and S3 24%. CAP and 1H-MRS significantly correlated
with histopathology and showed comparable accuracy for the detection of hepatic steatosis: areas under the receiveroperating
characteristics curves were 0.93 vs. 0.88 for steatosis $S1 and 0.94 vs. 0.88 for $S2, respectively. Boot-strapping
analysis revealed a CAP cut-off of 300 dB/m for detection of S2-3 steatosis, while retaining the lower cut-off of 215 dB/m for
the definition of healthy individuals. Direct comparison between CAP and 1H-MRS revealed only modest correlation (total
cohort: r = 0.63 [0.44, 0.76]; NAFLD cases: r = 0.56 [0.32, 0.74]). For detection of F2–4 fibrosis TE had sensitivity and specificity
of 100% and 98.1% at a cut-off value of 8.85 kPa.
Conclusion: Our data suggest a comparable diagnostic value of CAP and 1H-MRS for hepatic steatosis quantification.
Combined with the simultaneous TE fibrosis assessment, CAP represents an efficient method for non-invasive
characterization of NAFLD. Limited correlation between CAP and 1H-MRS may be explained by different technical aspects,
anthropometry, and presence of advanced liver fibrosis.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa.de:bsz:15-qucosa-142654 |
| Date | 07 May 2014 |
| Creators | Karlas , Thomas, Wiegand, Johannes |
| Contributors | Universität Leipzig, IFB AdiposityDiseases, University Medical Center, Public Library of Science,, Universität Leipzig, IFB AdiposityDiseases, University Medical Center |
| Publisher | Universitätsbibliothek Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | doc-type:article |
| Format | application/pdf |
| Source | PLoS ONE March 17, 2014 doi: 10.1371/journal.pone.0091987 |
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