A NEW COMBINED NON-INVASIVE METHOD FOR ASSESSMENT OF LIVER STEATOSIS AND FIBROSIS IN NAFLD PATIENTS-PILOT STUDY

The aim of this study was to investigate the clinical efficacy (sensitivity, specificity) of ultrasound-based imaging methods for the assessment of fibro-sis and steatosis in patients with non-alcoholic fatty liver disease (NAFLD). Sixty-six patients with NAFLD and 43 healthy volunteers (control group) were tested. Liver biopsy was used as a reference method for the evaluation of NAFLD. Liver stiffness measurement (LSM) with transient elastography (TE) and two-dimensional shear wave elastography (2D-SWE) was used to assess fi-brosis. Steatosis was assessed by Controlled Attenuation Parameter (CAP) and EchoLevels (ELs). Using the ELs, two hepato-renal indices were calculated - the hepato-renal index difference (HRIdiff) and hepato-renal index ratio (HRI-ratio). Additionally, one serum biomarker was calculated - APRI. Cut-offs of cirrhosis (F4) were defined as follows: > 9.64 kPa and > 9.85 kPa for 2D-SWE and TE. Only 2D-SWE had a correlation for significant fibrosis - the cut-off was > 6.50 kPa and for lack of significant fibrosis (F<2) less than 5.26 kPa. Steatosis was diagnosed with a cut-off of 240.50 dB/m for CAP, and HRIdiff > 0.39, and HRIratio <= 0.99 for ELs. Both types of SWE and the two methods for evaluation of ultrasound (US) attenuation have good correlation with fibrosis and steatosis in NAFLD.