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Acoustic structure quantification by using ultrasound Nakagami imaging for assessing liver fibrosis

View Article: PubMed Central - PubMed

ABSTRACT

Acoustic structure quantification (ASQ) is a recently developed technique widely used for detecting liver fibrosis. Ultrasound Nakagami parametric imaging based on the Nakagami distribution has been widely used to model echo amplitude distribution for tissue characterization. We explored the feasibility of using ultrasound Nakagami imaging as a model-based ASQ technique for assessing liver fibrosis. Standard ultrasound examinations were performed on 19 healthy volunteers and 91 patients with chronic hepatitis B and C (n = 110). Liver biopsy and ultrasound Nakagami imaging analysis were conducted to compare the METAVIR score and Nakagami parameter. The diagnostic value of ultrasound Nakagami imaging was evaluated using receiver operating characteristic (ROC) curves. The Nakagami parameter obtained through ultrasound Nakagami imaging decreased with an increase in the METAVIR score (p < 0.0001), representing an increase in the extent of pre-Rayleigh statistics for echo amplitude distribution. The area under the ROC curve (AUROC) was 0.88 for the diagnosis of any degree of fibrosis (≥F1), whereas it was 0.84, 0.69, and 0.67 for ≥F2, ≥F3, and ≥F4, respectively. Ultrasound Nakagami imaging is a model-based ASQ technique that can be beneficial for the clinical diagnosis of early liver fibrosis.

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The Nakagami parameters corresponding to each liver fibrosis stage.Data are expressed using box plots. The Nakagami parameter decreased with an increase in the histological fibrosis stage, representing an increase in the degree of pre-Rayleigh statistics for the echo amplitude distribution.
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f4: The Nakagami parameters corresponding to each liver fibrosis stage.Data are expressed using box plots. The Nakagami parameter decreased with an increase in the histological fibrosis stage, representing an increase in the degree of pre-Rayleigh statistics for the echo amplitude distribution.

Mentions: The characteristics of healthy volunteers in the control group are summarized in Table 1, and the patients’ demographic data and biological and histological findings are summarized in Table 2. Because the volunteers had a normal BMI and no remarkable past medical history or clinical symptoms of liver parenchymal diseases, the control group data were categorized as F0 for comparison with the patient data. The PR-stained section images obtained from patients with different stages of liver fibrosis are shown in Fig. 1. Figures 2 and 3 present the grayscale B-mode and Nakagami images obtained from the healthy volunteers and patients with liver fibrosis, respectively. The brightness of the Nakagami image typically decreased as the METAVIR scores increased from F1 to F4. The Nakagami parameters corresponding to each liver fibrosis stage are presented in Fig. 4. The dynamic range (i.e., the difference between the maximum and minimum values) of the Nakagami parameter was 0.53–0.85. The Nakagami parameter monotonically decreased as the severity of liver fibrosis increased (r = −0.45, p < 0.0001). The median Nakagami parameter was 0.77 (IQR: 0.73–0.79) for F0, 0.72 (IQR: 0.68–0.75) for F1, 0.68 (IQR: 0.64–0.70) for F2, 0.68 (IQR: 0.66–0.71) for F3, and 0.69 (IQR: 0.65–0.70) for F4. A significant difference was observed between F0 and F1 (p = 0.0006) and F1 and F2 (p = 0.0033). However, no significant difference was observed between F2 and F3 (p = 0.45) and F3 and F4 (p = 0.91). The ROC curves for diagnosing different liver fibrosis stages are presented in Fig. 5. The AUROCs (95% CI) were 0.88 (0.79–0.95), 0.84 (0.75–0.92), 0.69 (0.58–0.79), and 0.67 (0.56–0.77) for fibrosis stages ≥F1, ≥F2, ≥F3, and ≥F4, respectively. The performance profile for ultrasound Nakagami imaging is presented in Table 3.


Acoustic structure quantification by using ultrasound Nakagami imaging for assessing liver fibrosis
The Nakagami parameters corresponding to each liver fibrosis stage.Data are expressed using box plots. The Nakagami parameter decreased with an increase in the histological fibrosis stage, representing an increase in the degree of pre-Rayleigh statistics for the echo amplitude distribution.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5015103&req=5

f4: The Nakagami parameters corresponding to each liver fibrosis stage.Data are expressed using box plots. The Nakagami parameter decreased with an increase in the histological fibrosis stage, representing an increase in the degree of pre-Rayleigh statistics for the echo amplitude distribution.
Mentions: The characteristics of healthy volunteers in the control group are summarized in Table 1, and the patients’ demographic data and biological and histological findings are summarized in Table 2. Because the volunteers had a normal BMI and no remarkable past medical history or clinical symptoms of liver parenchymal diseases, the control group data were categorized as F0 for comparison with the patient data. The PR-stained section images obtained from patients with different stages of liver fibrosis are shown in Fig. 1. Figures 2 and 3 present the grayscale B-mode and Nakagami images obtained from the healthy volunteers and patients with liver fibrosis, respectively. The brightness of the Nakagami image typically decreased as the METAVIR scores increased from F1 to F4. The Nakagami parameters corresponding to each liver fibrosis stage are presented in Fig. 4. The dynamic range (i.e., the difference between the maximum and minimum values) of the Nakagami parameter was 0.53–0.85. The Nakagami parameter monotonically decreased as the severity of liver fibrosis increased (r = −0.45, p < 0.0001). The median Nakagami parameter was 0.77 (IQR: 0.73–0.79) for F0, 0.72 (IQR: 0.68–0.75) for F1, 0.68 (IQR: 0.64–0.70) for F2, 0.68 (IQR: 0.66–0.71) for F3, and 0.69 (IQR: 0.65–0.70) for F4. A significant difference was observed between F0 and F1 (p = 0.0006) and F1 and F2 (p = 0.0033). However, no significant difference was observed between F2 and F3 (p = 0.45) and F3 and F4 (p = 0.91). The ROC curves for diagnosing different liver fibrosis stages are presented in Fig. 5. The AUROCs (95% CI) were 0.88 (0.79–0.95), 0.84 (0.75–0.92), 0.69 (0.58–0.79), and 0.67 (0.56–0.77) for fibrosis stages ≥F1, ≥F2, ≥F3, and ≥F4, respectively. The performance profile for ultrasound Nakagami imaging is presented in Table 3.

View Article: PubMed Central - PubMed

ABSTRACT

Acoustic structure quantification (ASQ) is a recently developed technique widely used for detecting liver fibrosis. Ultrasound Nakagami parametric imaging based on the Nakagami distribution has been widely used to model echo amplitude distribution for tissue characterization. We explored the feasibility of using ultrasound Nakagami imaging as a model-based ASQ technique for assessing liver fibrosis. Standard ultrasound examinations were performed on 19 healthy volunteers and 91 patients with chronic hepatitis B and C (n&thinsp;=&thinsp;110). Liver biopsy and ultrasound Nakagami imaging analysis were conducted to compare the METAVIR score and Nakagami parameter. The diagnostic value of ultrasound Nakagami imaging was evaluated using receiver operating characteristic (ROC) curves. The Nakagami parameter obtained through ultrasound Nakagami imaging decreased with an increase in the METAVIR score (p&thinsp;&lt;&thinsp;0.0001), representing an increase in the extent of pre-Rayleigh statistics for echo amplitude distribution. The area under the ROC curve (AUROC) was 0.88 for the diagnosis of any degree of fibrosis (&ge;F1), whereas it was 0.84, 0.69, and 0.67 for &ge;F2, &ge;F3, and &ge;F4, respectively. Ultrasound Nakagami imaging is a model-based ASQ technique that can be beneficial for the clinical diagnosis of early liver fibrosis.

No MeSH data available.


Related in: MedlinePlus