Quantitative ultrasound in patients with liver steatosis and non-alcoholic steatohepatitis

The assessment of patients presenting with liver steatosis or suspicion of non-alcoholic steatohepatitis has become mandatory with the increasing incidence of fatty liver disease. Ultrasound (US) provides significant advantages as quantitative parameters can be acquired during a routine liver examination. Two aspects can be studied quantitatively: liver stiffness and fatty infiltration.

The US examination can be conducted with two types of transducers depending on a patient morphotype: the DAX transducer and the convex high frequency 9C2 transducer. Several measurements can be acquired using Point and Auto Point Shear Wave elastography, with 10 to 15 simultaneous measurements. A double screen window with the display of real-time B-mode for guidance and elasticity measurement combined with quality maps is useful to allow artifact identification where a large ROI can be fitted to anatomical structure. In addition, liver stiffness can be assessed with true quantitative measurement in kPa or m/sec.

Ultrasound Derived Fat Fraction (UDFF) was introduced using the DAX transducer and the 9C2. Preliminary data of an ongoing study will be discussed, and tips and tricks will be shared. Optimal acquisition and improved reproducibility will be addressed during this hands-on session.