Acoustic structure quantification by using ultrasound Nakagami imaging for assessing liver fibrosis - PubMed (original) (raw)

Acoustic structure quantification by using ultrasound Nakagami imaging for assessing liver fibrosis

Po-Hsiang Tsui et al. Sci Rep. 2016.

Abstract

Acoustic structure quantification (ASQ) is a recently developed technique widely used for detecting liver fibrosis. Ultrasound Nakagami parametric imaging based on the Nakagami distribution has been widely used to model echo amplitude distribution for tissue characterization. We explored the feasibility of using ultrasound Nakagami imaging as a model-based ASQ technique for assessing liver fibrosis. Standard ultrasound examinations were performed on 19 healthy volunteers and 91 patients with chronic hepatitis B and C (n = 110). Liver biopsy and ultrasound Nakagami imaging analysis were conducted to compare the METAVIR score and Nakagami parameter. The diagnostic value of ultrasound Nakagami imaging was evaluated using receiver operating characteristic (ROC) curves. The Nakagami parameter obtained through ultrasound Nakagami imaging decreased with an increase in the METAVIR score (p < 0.0001), representing an increase in the extent of pre-Rayleigh statistics for echo amplitude distribution. The area under the ROC curve (AUROC) was 0.88 for the diagnosis of any degree of fibrosis (≥F1), whereas it was 0.84, 0.69, and 0.67 for ≥F2, ≥F3, and ≥F4, respectively. Ultrasound Nakagami imaging is a model-based ASQ technique that can be beneficial for the clinical diagnosis of early liver fibrosis.

PubMed Disclaimer

Figures

Figure 1

Figure 1. PR-stained sections (100 magnification) obtained from patients’ livers with different degrees of fibrosis from F0 to F4.

(a) F0: no fibrosis; (b) F1: fibrous expansion of portal areas without septa (i.e., portal fibrosis); (c) F2: portal fibrosis with few septa was observed; (d) F3: fibrous expansion of portal areas with marked bridging or septa (i.e., septal fibrosis); (e) F4: the tissue is composed of nodules surrounded completely by fibrosis (i.e., cirrhosis).

Figure 2

Figure 2. Grayscale B-mode images obtained from the healthy volunteers and patients with liver fibrosis.

(a) F0; (b) F1; (c) F2; (d) F3; (e) F4. B-mode images were reconstructed using log-compressed envelopes of ultrasound signals provided by the Terason ultrasound scanner.

Figure 3

Figure 3. Ultrasound Nakagami images obtained from the healthy volunteers and patients with liver fibrosis.

(a) F0; (b) F1; (c) F2; (d) F3; (e) F4. The brightness of the Nakagami image typically decreased as the METAVIR scores increased from F0 to F4.

Figure 4

Figure 4. The Nakagami parameters corresponding to each liver fibrosis stage.

Data are expressed using box plots. The Nakagami parameter decreased with an increase in the histological fibrosis stage, representing an increase in the degree of pre-Rayleigh statistics for the echo amplitude distribution.

Figure 5

Figure 5. ROC curves for diagnosing different liver fibrosis stages.

The AUROC obtained using ultrasound Nakagami imaging in our study was 0.88, 0.84, 0.69, and 0.67 for ≥F1, ≥F2, ≥F3, and ≥F4, respectively.

References

    1. Barr R. G. et al. Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology 276, 845–861 (2015). - PubMed
    1. Regev A. et al. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 97, 2614–2618 (2002). - PubMed
    1. Ratziu V. et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 128, 1898–1906 (2005). - PubMed
    1. Berzigotti A. & Castera L. Update on ultrasound imaging of liver fibrosis. J Hepatol 59, 180–182 (2013). - PubMed
    1. Huang Y. et al. Assessment of liver fibrosis in chronic hepatitis B using acoustic structure quantification: quantitative morphological ultrasound. Eur Radiol 26, 2344–2351 (2016). - PubMed

Publication types

MeSH terms

LinkOut - more resources