Journal Article

Noninvasive Quantification of Hepatic Steatosis Using Ultrasound‐Derived Fat Fraction (CHESS2303): A Prospective Multicenter Study

Song, Danlei, Wang, Zhou, Liu, Chuan, Wang, Ying, Shao, Chuxiao, Cheng, Juan, Qi, Ruixiang, Jiang, Fan, Wang, Wenping, Dong, Yi, Xie, Xiang, Wong, Vincent Wai‐Sun, Seto, Wai‐Kay, Huang, Yunlin, Gao, Youfang, Lu, Liren, Dietrich, Christoph F., Jiang, Longfeng, Yao, Wang, Rong, Pengfei, Li, Jia, Shan, Rong, Lv, Jiaojian, Zhu, Chuanlong, Ren, Yongfeng, Qi, Xiaolong, Long, Siqin, Wang, Hao

2025

Overview

Ultrasound‐derived fat fraction (UDFF) is designed to assess the hepatic fat content quantitatively. A multicenter study that verifies the diagnostic performance of UDFF for detecting hepatic steatosis has not yet been reported. This study aimed to evaluate the performance of UDFF for diagnosing and grading hepatic steatosis. Participants referred for assessment of hepatic steatosis were prospectively recruited from eight hospitals. All participants underwent UDFF and magnetic resonance imaging proton density fat fraction (MRI‐PDFF) examinations. MRI‐PDFF was used as the reference for diagnosing hepatic steatosis. From January 2023 to July 2023, a total of 300 participants were included. The median body mass index was 25.4 kg/m2 (interquartile range: 22.7–28.1). UDFF values were positively correlated with MRI‐PDFF (R = 0.80, p < 0.001). Using MRI‐PDFF ≥ 5%, ≥ 15%, and ≥ 25% as the reference standard for detecting mild, moderate, and severe hepatic steatosis, the best cutoff values of UDFF were 7.6% (area under the receiver operating characteristic curves [AUC] = 0.90), 15.9% (AUC = 0.90), and 22.3% (AUC = 0.91), respectively. Thus, UDFF has excellent diagnostic performance in detecting and grading hepatic steatosis. In this prospective multicenter study, UDFF values were positively correlated with MRI‐PDFF (R = 0.80). Taking MRI‐PDFF ≥ 5%, ≥ 15%, and ≥ 25% as the reference for diagnosing mild, moderate, and severe hepatic steatosis, the cutoff values of UDFF were 7.6%, 15.9%, and 22.3% in the training set (AUC = 0.90–0.91), respectively. UDFF achieved comparable AUCs in the validation set.

• Publisher: John Wiley & Sons, Inc,Wiley
• Subject: Fatty liver / hepatic steatosis / Magnetic resonance imaging / magnetic resonance imaging proton density fat fraction (MRI‐PDFF) / noninvasive / Performance evaluation / quantification / Ultrasonic imaging / ultrasound‐derived fat fraction (UDFF)