A Practical Approach to Quantitative Grayscale Ultrasound Analysis of Hepatic Steatosis in Pediatric Patients Using a Picture Archiving and Communication System–Based Tool

Objectives To evaluate the efficacy of a picture archiving and communication system (PACS)‐based ultrasound (US) quantification technique for diagnosis of hepatic steatosis in a pediatric population. Methods Abdominal US images of 49 pediatric patients (≤18 years) with histopathologically proven dia...

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Bibliographic Details
Published in:Journal of ultrasound in medicine 2018-10, Vol.37 (10), p.2395-2403
Main Authors: Erdem Toslak, Iclal, Lim‐Dunham, Jennifer E., Joyce, Cara, Marbella, Marko E.
Format: Article
Language:English
Subjects:
Adolescent
Child
echo intensity
Fatty Liver - diagnostic imaging
Female
grayscale
hepatic steatosis
Humans
Image Processing, Computer-Assisted - methods
liver
Liver - diagnostic imaging
Male
pediatrics
Radiology Information Systems
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
Ultrasonography - methods
ultrasound
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Summary:Objectives To evaluate the efficacy of a picture archiving and communication system (PACS)‐based ultrasound (US) quantification technique for diagnosis of hepatic steatosis in a pediatric population. Methods Abdominal US images of 49 pediatric patients (≤18 years) with histopathologically proven diagnoses of hepatic steatosis (n = 17), nonsteatotic liver disease (n = 19), and a normal liver (n = 13) were retrospectively reviewed. Patient demographics, the fibrosis stage, and the steatosis grade were obtained from the database. Quantitative grayscale measurements of the echo intensity level of the liver and kidneys were performed on the US images using the PACS measuring tool. The hepatorenal ratio was obtained by dividing mean liver by mean kidney values. The heterogeneity index for the liver was calculated by dividing the liver standard deviation by mean liver values. Hepatorenal ratio and heterogeneity index values of the 3 groups were correlated with pathologic results and compared by a 1‐way analysis of variance. A receiver operating characteristic curve analysis was performed, and cutoff values were determined. Results The hepatorenal ratio of the hepatic steatosis group was significantly greater than those of the control and nonsteatotic liver disease groups (P 
ISSN:0278-4297
1550-9613
DOI:10.1002/jum.14598