Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility Study

Ultrasound imaging is a first-line assessment tool for hepatic steatosis. Properties of tissue microstructures correlate with the statistical distribution of ultrasound backscattered signals, which can be described by the Nakagami distribution (a widely adopted approximation of backscattered statist...

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Main Authors: Feng Fang, Jui Fang, Qiang Li, Dar-In Tai, Yung-Liang Wan, Kazuki Tamura, Tadashi Yamaguchi, Po-Hsiang Tsui
Format: Article
Language:English
Published: MDPI AG 2020-08-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/10/8/557
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author Feng Fang
Jui Fang
Qiang Li
Dar-In Tai
Yung-Liang Wan
Kazuki Tamura
Tadashi Yamaguchi
Po-Hsiang Tsui
author_facet Feng Fang
Jui Fang
Qiang Li
Dar-In Tai
Yung-Liang Wan
Kazuki Tamura
Tadashi Yamaguchi
Po-Hsiang Tsui
author_sort Feng Fang
collection DOAJ
description Ultrasound imaging is a first-line assessment tool for hepatic steatosis. Properties of tissue microstructures correlate with the statistical distribution of ultrasound backscattered signals, which can be described by the Nakagami distribution (a widely adopted approximation of backscattered statistics). The double Nakagami distribution (DND) model, which combines two Nakagami distributions, was recently proposed for using high-frequency ultrasound to analyze backscattered statistics corresponding to lipid droplets in the fat-infiltrated liver. This study evaluated the clinical feasibility of the DND model in ultrasound parametric imaging of hepatic steatosis by conducting clinical experiments using low-frequency ultrasound dedicated to general abdominal examinations. A total of 204 patients were recruited, and ultrasound image raw data were acquired using a 3.5 MHz array transducer for DND parametric imaging using the sliding window technique. The DND parameters were compared with hepatic steatosis grades identified histologically. A receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance. The results indicated that DND parametric imaging constructed using a sliding window with the side length of five times the pulse length of the transducer provided stable and reliable DND parameter estimations and visualized changes in the backscattered statistics caused by hepatic steatosis. The DND parameter increased with the hepatic steatosis grade. The areas under the ROC curve for identifying hepatic steatosis were 0.76 (≥mild), 0.81 (≥moderate), and 0.82 (≥severe). When using low-frequency ultrasound, DND imaging allows the clinical detection of hepatic steatosis and reflects information associated with lipid droplets in the fat-infiltrated liver.
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spelling doaj.art-4172e1ca096c4cfeb301e64e0937a5552023-11-20T09:04:50ZengMDPI AGDiagnostics2075-44182020-08-0110855710.3390/diagnostics10080557Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility StudyFeng Fang0Jui Fang1Qiang Li2Dar-In Tai3Yung-Liang Wan4Kazuki Tamura5Tadashi Yamaguchi6Po-Hsiang Tsui7School of Microelectronics, Tianjin University, Tianjin 300072, Chinax-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung 404332, TaiwanSchool of Microelectronics, Tianjin University, Tianjin 300072, ChinaDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan 33305, TaiwanDepartment of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, TaiwanPreeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Shizuoka 431-3192, JapanCenter for Frontier Medical Engineering, Chiba University, Chiba 263-8522, JapanDepartment of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, TaiwanUltrasound imaging is a first-line assessment tool for hepatic steatosis. Properties of tissue microstructures correlate with the statistical distribution of ultrasound backscattered signals, which can be described by the Nakagami distribution (a widely adopted approximation of backscattered statistics). The double Nakagami distribution (DND) model, which combines two Nakagami distributions, was recently proposed for using high-frequency ultrasound to analyze backscattered statistics corresponding to lipid droplets in the fat-infiltrated liver. This study evaluated the clinical feasibility of the DND model in ultrasound parametric imaging of hepatic steatosis by conducting clinical experiments using low-frequency ultrasound dedicated to general abdominal examinations. A total of 204 patients were recruited, and ultrasound image raw data were acquired using a 3.5 MHz array transducer for DND parametric imaging using the sliding window technique. The DND parameters were compared with hepatic steatosis grades identified histologically. A receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance. The results indicated that DND parametric imaging constructed using a sliding window with the side length of five times the pulse length of the transducer provided stable and reliable DND parameter estimations and visualized changes in the backscattered statistics caused by hepatic steatosis. The DND parameter increased with the hepatic steatosis grade. The areas under the ROC curve for identifying hepatic steatosis were 0.76 (≥mild), 0.81 (≥moderate), and 0.82 (≥severe). When using low-frequency ultrasound, DND imaging allows the clinical detection of hepatic steatosis and reflects information associated with lipid droplets in the fat-infiltrated liver.https://www.mdpi.com/2075-4418/10/8/557fatty liverhepatic steatosisultrasoundNakagami distribution
spellingShingle Feng Fang
Jui Fang
Qiang Li
Dar-In Tai
Yung-Liang Wan
Kazuki Tamura
Tadashi Yamaguchi
Po-Hsiang Tsui
Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility Study
Diagnostics
fatty liver
hepatic steatosis
ultrasound
Nakagami distribution
title Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility Study
title_full Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility Study
title_fullStr Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility Study
title_full_unstemmed Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility Study
title_short Ultrasound Assessment of Hepatic Steatosis by Using the Double Nakagami Distribution: A Feasibility Study
title_sort ultrasound assessment of hepatic steatosis by using the double nakagami distribution a feasibility study
topic fatty liver
hepatic steatosis
ultrasound
Nakagami distribution
url https://www.mdpi.com/2075-4418/10/8/557
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