Non-Invasive Photothermal Strain Imaging of Non-Alcoholic Fatty Liver Disease in Live Animals

The prevalence of non-alcoholic fatty liver diseases (NAFLD) has increased steadily over the past decade. Thus, diagnosing NAFLD at the earliest stage, which is a reversible condition, has become increasingly important. Here, photothermal strain imaging (pTSI) is presented as a novel non-invasive tool for NAFLD diagnosis. The pTSI uses ultrasound to detect the difference in thermal strain between fat and water during a light-induced temperature rise, which is directly related to the pathological evidence of NAFLD. To demonstrate its feasibility, fat accumulation in in vivo rat livers is monitored non-invasively using pTSI, based on clinical ultrasound B-mode images. A total of 21 male Wistar rats of 3 weeks of age were prepared. Of these, 18 rats received methionine-choline deficient diet for 1 to 6 weeks (n = 3 per week) to induce NAFLD, whereas 3 rats received normal diet as controls (n = 3). Livers were heated by a lipid-sensitive continuous-wave laser, and strain was measured. Quantitative results from the pTSI were compared with histological analysis results using Oil-Red-O (ORO). The receiver operating characteristic curve of in vivo pTSI results for detecting moderate steatosis (ORO-stained area >= 33%) was constructed based on strain change rate measured in the liver region. The sensitivity and specificity of pTSI were 90% and 82%, respectively, and the area-under-the-curve was measured as 0.85 +/- 0.03 (95% confidence interval). The pTSI results tested in the rodent NAFLD model showed great potential for pTSI to be used as a new diagnostic tool for NAFLD in the future.