Chih-Hao LinMING-CHIH HOPO-CHU LEEPO-JEN YANGCHIUNG-NIEN CHENYUNG-MING JENGJIA-HUEI TSAIARGON CHEN2024-07-172024-07-172024-080041624Xhttps://www.scopus.com/record/display.uri?eid=2-s2.0-85196819246&origin=resultslisthttps://scholars.lib.ntu.edu.tw/handle/123456789/719877Diagnosis of early hepatic steatosis would allow timely intervention. B-mode ultrasound imaging was in question for detecting early steatosis, especially with a variety of concomitant parenchymal disease. This study aimed to use the surgical specimen as a reference standard to elucidate the clinical performance of ultrasonic echogenicity and backscatter parametric and nonparametric statistics in real-world scenarios. Ultrasound radio-frequency (RF) signals of right liver lobe and patient data were collected preoperatively. Surgical specimen was then used to histologically determine staging of steatosis. A backscatter nonparametric statistic (h), a known backscatter parametric statistic, i.e., the Nakagami parameter (m), and a quantitative echo intensity (env) were calculated. Among the 236 patients included in the study, 93 were grade 0 (<5% fat) and 143 were with steatosis. All the env, m and h statistics had shown significant discriminatory power of steatosis grades (AUC = 0.643–0.907 with p-value < 0.001). Mann-Whitney U tests, however, revealed that only the backscatter statistics m and h were significantly different between the groups of grades 0 and 1 steatosis. The two-way ANOVA showed a significant confounding effect of the elevated ALT on env (p-value = 0.028), but no effect on m or h. Additionally, the severe fibrosis was found to be a significant covariate for m and h. Ultrasonic signals acquired from different scanners were found linearly comparable.falseHepatic steatosisHepatitisLiver fibrosisNonparametric statisticsUltrasonic backscattered signalsjournal article10.1016/j.ultras.2024.1073912-s2.0-85196819246