Ultrasonographic assessment of liver fibrosis with computer-assisted analysis of liver surface irregularities.
OBJECTIVE
The goal of this study was to evaluate the diagnostic accuracy of a software program that automatically analyzes the liver surface to diagnose significant fibrosis, by comparing it to the subjective analysis of a radiologist and to transient elastography (Fibroscan(®)).


METHODS
One hundred fourteen patients with chronic liver disease were included in the study. They underwent liver biopsy, FibroScan(®) and ultrasonographic examination of the liver surface. The liver surface was analyzed by a software program that gave a score of surface irregularities. This evaluation was compared to subjective analysis by a radiologist expert in liver imaging and by two general radiologists.


RESULTS
Fifty percent of the patients had significant fibrosis according to the METAVIR score. The AUROC for the diagnosis of significant fibrosis by the software program was 0.80 (95%CI: 0.71-0.87), which was equivalent (P=0.86) to that of FibroScan(®) (0.81; 95%CI: 0.71-0.89). Results of the subjective analysis by the expert radiologist were poorer than those of the software analysis (P=0.02) (AUROC=0.66; 95%CI: 0.56-0.75). Interobserver agreement among radiologists was poor (0.25<kappa<0.37).


CONCLUSIONS
Computer-assisted liver surface analysis was better than subjective analysis, and similar to that of the FibroScan(®). This method could be useful for the diagnosis of significant fibrosis in patients with chronic hepatitis and complementary to the other non-invasive diagnostic tests.
Service de radiologie et imagerie médicale, CHU de Grenoble, Cs 10217, boulevard de la Chantourne, 38043 Grenoble cedex 9, France. Electronic address: nhuet@chu-grenoble.fr.
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N
Huet
Service de radiologie générale, Hôpital de Chambéry, 7, square Massalaz, 73000 Chambéry, France.
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I
Denis
Service de radiologie et imagerie médicale, CHU de Grenoble, Cs 10217, boulevard de la Chantourne, 38043 Grenoble cedex 9, France.
A
A
Martino
Service d'imagerie médicale, Hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
B
B
Gallix
Service d'anatomo-pathologie, CHU de Grenoble, Cs 10217, 38043 Grenoble cedex 9, France.
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N
Sturm
Service d'hépato-gastro-entérologie, CHU de Grenoble, Cs 10217, 38043 Grenoble cedex 9, France.
V
V
Leroy
Service de radiologie et imagerie médicale, CHU de Grenoble, Cs 10217, boulevard de la Chantourne, 38043 Grenoble cedex 9, France; Université Grenoble Alpes, TIMC-IMAG, 38000 Grenoble, France.
I
I
Bricault
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006521:Hepatitis, Chronic / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012984:Software; D055815:Young Adult
Computer-assisted image analysis; Liver fibrosis; Ultrasound