WFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat Quantification

Giovanna Ferraioli; Richard Gary Barr; Annalisa Berzigotti; Ioan Sporea; Vincent Wai-Sun Wong; Thomas Reiberger; Thomas Karlas; Maja Thiele; Ana Carolina Cardoso; Oyekoya Taiwo Ayonrinde; Laurent Castera; Christoph Frank Dietrich; Hiroko Iijima; Dong Ho Lee; William Kemp; Claudia P Oliveira; Shiv Kumar Sarin

doi:10.1016/j.ultrasmedbio.2024.03.014

WFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat Quantification

Ultrasound Med Biol. 2024 Apr 23:S0301-5629(24)00143-1. doi: 10.1016/j.ultrasmedbio.2024.03.014. Online ahead of print.

Authors

Giovanna Ferraioli¹, Richard Gary Barr², Annalisa Berzigotti³, Ioan Sporea⁴, Vincent Wai-Sun Wong⁵, Thomas Reiberger⁶, Thomas Karlas⁷, Maja Thiele⁸, Ana Carolina Cardoso⁹, Oyekoya Taiwo Ayonrinde¹⁰, Laurent Castera¹¹, Christoph Frank Dietrich¹², Hiroko Iijima¹³, Dong Ho Lee¹⁴, William Kemp¹⁵, Claudia P Oliveira¹⁶, Shiv Kumar Sarin¹⁷

Affiliations

¹ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. Electronic address: giovanna.ferraioli@unipv.it.
² Department of Radiology, Northeastern Ohio Medical University, Youngstown, OH, USA.
³ Department for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁴ Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.
⁵ Department of Medicine and Therapeutics, Medical Data Analytics Centre, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁶ Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria; Christian-Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, Vienna, Austria.
⁷ Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany.
⁸ Center for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; Department for Clinical Research, University of Southern Denmark, Odense, Denmark.
⁹ Hepatology Division, School of Medicine, Federal University of Rio de Janeiro, Clementino, Fraga Filho Hospital, Rio de Janeiro, RJ, Brazil.
¹⁰ Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA, Australia; Medical School, The University of Western Australia, Crawley, WA, Australia; Curtin Medical School, Curtin University, Bentley, WA, Australia.
¹¹ Université Paris-Cité, Inserm UMR1149, Centre de Recherche sur l'Inflammation, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, Clichy, France.
¹² Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem and Permancence, Bern, Switzerland.
¹³ Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Disease, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Ultrasound Imaging Center, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
¹⁴ Department of Radiology, College of Medicine, Seoul National University Hospital, Seoul National University, Seoul, Republic of Korea.
¹⁵ Department of Gastroenterology, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia.
¹⁶ Gastroenterology Department, Laboratório de Investigação (LIM07), Hospital das Clínicas de São Paulo, HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
¹⁷ Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

PMID: 38658207
DOI: 10.1016/j.ultrasmedbio.2024.03.014

Abstract

The World Federation for Ultrasound in Medicine and Biology (WFUMB) has promoted the development of this document on multiparametric ultrasound. Part 2 is a guidance on the use of the available tools for the quantification of liver fat content with ultrasound. These are attenuation coefficient, backscatter coefficient, and speed of sound. All of them use the raw data of the ultrasound beam to estimate liver fat content. This guidance has the aim of helping the reader in understanding how they work and interpret the results. Confounding factors are discussed and a standardized protocol for measurement acquisition is suggested to mitigate them. The recommendations were based on published studies and experts' opinion but were not formally graded because the body of evidence remained low at the time of drafting this document.

Keywords: Attenuation coefficient; Attenuation imaging; Controlled attenuation parameter; Fatty liver; Liver steatosis; MAFLD; MASH; MASLD; NAFLD; NASH.

Publication types

Review