Prospective, Same-day, Direct Comparison of CAP With the M vs the XL Probe in Patients With Nonalcoholic Fatty Liver Disease, Using Magnetic Resonance Imaging Proton Density Fat Fraction as the Standard

Autor: Sirlin, C. B., Loomba, R., Caussy, C., Brissot, J., Singh, S., Bassirian, S., Hernandez, C., Bettencourt, R., Rizo, E., Richards, L.
Přispěvatelé: Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Indian Space Research Organisation (ISRO), Institut de Recherche sur la Fusion par confinement Magnétique (IRFM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Department of Oceanography and Fisheries, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), UC San Diego NAFLD Research Center, School of Medicine [Univ California San Diego] (UC San Diego), University of California [San Diego] (UC San Diego), University of California (UC)-University of California (UC)-University of California [San Diego] (UC San Diego), University of California (UC)-University of California (UC), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), UC San Diego School of Medicine
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2019, ⟨10.1016/j.cgh.2019.11.060⟩
Clinical Gastroenterology and Hepatology
Clinical Gastroenterology and Hepatology, In press, 18 (8), pp.1842. ⟨10.1016/j.cgh.2019.11.060⟩
Clinical Gastroenterology and Hepatology, WB Saunders, In press, 18 (8), pp.1842. ⟨10.1016/j.cgh.2019.11.060⟩
ISSN: 1542-3565
Popis: International audience; BACKGROUND & AIMS: Controlled attenuation parameter (CAP) measurements using M probe have been reported to be lower than those of the XL-probe in detection of hepatic steatosis. However, there has been no direct comparison of CAP with the M vs the XL probe in patients with nonalcoholic fatty liver disease (NAFLD). We compared CAP with the M vs the XL probe for quantification of hepatic fat content, using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the standard. METHODS: We performed a prospective study of 100 adults (mean body mass index [BMI], 30.6+/-4.7 kg/m2) with and without NAFLD, assessed by CAP with the M probe and XL probe on the same day, at a single research center, from November 2017 through November 2018. We then measured the MRI-PDFF as the reference standard. Outcomes were presence of hepatic steatosis, defined as MRI-PDFF \textgreater/= 5%, and detection of hepatic fat content \textgreater/= 10%, defined as MRI-PDFF \textgreater/= 10%. We performed area under the receiver operating characteristic curve (AUROC) analyses to assess the diagnostic accuracy of CAP for each probe in detection of hepatic steatosis (MRI-PDFF \textgreater/= 5%) and of hepatic fat content \textgreater/= 10%. RESULTS: Of the study participants, 68% had an MRI-PDFF of 5% or more and 48% had an MRI-PDFF of 10% or more. The mean CAP measured by the M probe (310+/-62 db/m) was significantly lower than by the X probe (317+/-63 db/m) (P=.007). When M probe was used in participants with BMIs \textless30 kg/m(2) and XL probe in participants with BMIs \textgreater/=30 kg/m(2), the CAP measured by the M probe (312+/-51.4 db/m) remained significantly lower than that of the XL probe (345+/-47.6 db/m) (P=.0035.), when the MRI-PDFF was above 5%. The optimal threshold of CAP for the detection of MRI-PDFF\textgreater/=5%, was 294 db/m with the M probe and 307 db/m with the XL probe. The optimal threshold of CAP for the detection of MRI-PDFF \textgreater/= 10%, was 311 db/m with the M probe and 322 db/m with the XL probe. For only the XL probe, CAP measurements with an interquartile range below 30 dB/m detected an MRI-PDFF\textgreater/=5% with a lower AUROC (0.97; 95% CI, 0.80-1.00) than CAP measurements with an interquartile range above 30 dB/m (AUROC, 0.82; 95% CI, 0.71-0.90) (P=.0129). CONCLUSIONS: In an analysis of the same patients using CAP with the M probe and XL probe, with MRI-PDFF as the standard, we found that the M probe under-quantifies CAP values compared with the XL probe, independent of BMI. The type of probe should be considered when interpreting CAP data from patients with NAFLD.
Databáze: OpenAIRE
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