Optimal cutoff value for assessing changes in intrahepatic fat amount by using the controlled attenuation parameter in a longitudinal settingopen access
- Authors
- Ahn, Sang Bong; Jun, Dae Won; Kang, Bo-kyeong; Kim, Mimi; Chang, Misoo; Nam, Eunwoo
- Issue Date
- Dec-2018
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- controlled attenuation parameter; fatty liver; hepatic steatosis
- Citation
- MEDICINE, v.97, no.50
- Indexed
- SCIE
SCOPUS
- Journal Title
- MEDICINE
- Volume
- 97
- Number
- 50
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/15258
- DOI
- 10.1097/MD.0000000000013636
- ISSN
- 0025-7974
- Abstract
- The controlled attenuation parameter (CAP) has shown a good correlation with the intrahepatic fat amount in cross-sectional studies. However, there is no study on whether the change of CAP scores can also show good correlation in a longitudinal setting. Therefore, we investigated the correlation between CAP and magnetic resonance imaging-estimated proton density fat fraction (MR PDFF) through serial examination in a longitudinal setting. Sixty-five patients with nonalcoholic fatty liver disease were evaluated with MR PDFF and transient elastography including CAP at baseline and 3 months later. The CAP and MR PDFF at baseline showed a strong correlation in assessing hepatic steatosis (r=0.66, P<. 001). After treatment, the correlation between the change in CAP after treatment and the intrahepatic fat change (%) on MR PDFF was not satisfactory (r=0.37, P=.005) in the longitudinal setting. The optimal cutoff value of the change in CAP for discriminating an improvement or an aggravation in intrahepatic fat percentage (>1% change in MR PDFF) was selected as 38dB/m (area under the receiver operating characteristic curve=0.559). For CAP changes>38dB/m, the predictive value was 14/16 (87.5%), whereas for changes< 38dB/m, the predictive value was 12/41 (29.3%). Thereby, the accuracy of the method using the change in CAP was only 26/57 (46%). In addition, Cohen's kappa value was not significant (k=0.11, P=.186). Careful interpretation of the steatosis change based on the CAP score is needed when the absolute change value is< 38dB/m in a longitudinal setting.
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