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Quick assessment with controlled attenuation parameter for hepatic steatosis in children based on MRI-PDFF as the gold standard

 Jaeseung Shin  ;  Myung-Joon Kim  ;  Hyun Joo Shin  ;  Haesung Yoon  ;  Seung Kim  ;  Hong Koh  ;  Mi-Jung Lee 
 BMC PEDIATRICS, Vol.19(1) : 112, 2019 
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Children ; Controlled attenuation parameter ; Fatty liver ; Non-alcoholic fatty liver disease ; Proton density fat fraction
BACKGROUND: Controlled attenuation parameter (CAP) is a recently introduced, non-invasive and quantitative method to evaluate hepatic steatosis demonstrated in adults, but limited in obesity and not well evaluated in children. The aim of this study was to investigate the diagnostic performance for assessing hepatic steatosis grades using CAP in children based on MR proton density fat fraction (PDFF). METHODS: Children evaluated for non-alcoholic fatty liver disease (NAFLD) who were assessed for PDFF and CAP were enrolled retrospectively. Hepatic steatosis grades 0-3 were classified according to PDFF using cutoff values of 6, 17.5, and 23.3%. Subgroup analyses were performed in non-obese and obese groups using the 95th percentile body mass index (BMI) as a cutoff and BMI30 group when BMI > 30 kg/m2. Pearson's correlations between variables were also analyzed. RESULTS: In a total of 86 children, there were 53 in the obese group including 17 of the BMI30 group. CAP demonstrated 98.7% sensitivity and 80% specificity for diagnosing grades 1-3 vs. grade 0 using a cutoff value of 241 dB/m (area under the curve = 0.941, p < 0.001). The diagnostic performance for higher steatosis grades was suboptimal. CAP correlated with abdominal wall thickness in both obese (r = 0.549, p = 0.001) and non-obese (r = 0.386, p = 0.004) groups and did not correlate with PDFF in BMI30 group. CONCLUSION: In children with NAFLD, CAP showed excellent diagnostic performance for differentiating presence and absence of hepatic steatosis using a cutoff value of 241 dB/m. However, CAP was limited in evaluating grades of steatosis, especially in children with BMI > 30 kg/m2.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Kim, Seung(김승) ORCID logo https://orcid.org/0000-0003-4373-9828
Shin, Jaeseung(신재승) ORCID logo https://orcid.org/0000-0002-6755-4732
Shin, Hyun Joo(신현주) ORCID logo https://orcid.org/0000-0002-7462-2609
Yoon, Haesung(윤혜성) ORCID logo https://orcid.org/0000-0003-0581-8656
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
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