ScholarWorks@성균관대학교

초록

Purpose: Ultrasound fat fraction estimation (USFF) using quantitative ultrasonography (QUS) is a promising method for assessing liver fat in metabolic dysfunction-associated steatotic liver disease (MASLD). However, its performance across different ethnicities remains unclear. This study aimed to externally validate and compare USFF accuracy in Asian and Caucasian cohorts. Methods: This retrospective analysis used QUS data from three institutions. Participants underwent QUS and magnetic resonance imaging of the proton density fat fraction (MRI-PDFF), the reference standard. A multivariable regression model was developed using two QUS parameters. Linear regression was used to estimate fat fraction, with adjusted R-2 values assessing model fit. The diagnostic performance of USFF for hepatic fat content thresholds (>= 5%, >= 10%, >= 20%) was evaluated using the area under the receiver operating characteristic curve (AUC). Results: The development set included 427 South Korean participants, while the validation set comprised 100 from Hungary and 79 from Italy. R-2 values were 0.689, 0.702, and 0.485 for the development, internal validation, and external validation sets, respectively. AUC for detecting hepatic steatosis (MRI-PDFF >= 5%) was 0.939 (development) and 0.863 (external validation). Using a cutoff > 0.513, USFF achieved 85.1% sensitivity and 87.4% specificity. Conclusion: USFF is effective but shows variability across populations, highlighting the need for ethnicity-specific models.

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