title: Can early hepatic fibrosis stages be discriminated by combining ultrasonic parameters?
abstract: In this study, we put forward a new approach to classify early stages of fibrosis based on a multiparametric characterization using backscatter ultrasonic signals. Ultrasonic parameters, such as backscatter coefficient (Bc), speed of sound (SoS), attenuation coefficient (Ac), mean scatterer spacing (MSS), and spectral slope (SS), have shown their potential to differentiate between healthy and pathologic samples in different organs (eye, breast, prostate, liver). Recently, our group looked into the characterization of stages of hepatic fibrosis using the parameters cited above. The results showed that none of them could individually distinguish between the different stages. Therefore, we explored a multiparametric approach by combining these parameters in two and three, to test their potential to discriminate between the stages of liver fibrosis: F0 (normal), F1, F3, and/without F4 (cirrhosis), according to METAVIR Score. Discriminant analysis showed that the most relevant individual parameter was Bc, followed by SoS, SS, MSS, and Ac. The combination of (Bc, SoS) along with the four stages was the best in differentiating between the stages of fibrosis and correctly classified 85% of the liver samples with a high level of significance (p<0.0001). Nevertheless, when taking into account only stages F0, F1, and F3, the discriminant analysis showed that the parameters (Bc, SoS) and (Bc, Ac) had a better classification (93%) with a high level of significance (p<0.0001). The combination of the three parameters (Bc, SoS, and Ac) led to a 100% correct classification. In conclusion, the current findings show that the multiparametric approach has great potential in differentiating between the stages of fibrosis, and thus could play an important role in the diagnosis and follow-up of hepatic fibrosis.
authors.affiliation: Laboratoire de Magnétisme et de Spectroscopie des Solides (LM2S), Université Badji Mokhtar, Annaba 23000, Algeria. Electronic address: mirazika75@yahoo.fr.
authors.forename: Razika
authors.initials: R
authors.lastname: Bouzitoune
authors.affiliation: Laboratoire de Magnétisme et de Spectroscopie des Solides (LM2S), Université Badji Mokhtar, Annaba 23000, Algeria. Electronic address: mahmoud.meziri@gmail.com.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Meziri
authors.affiliation: Biomedical Ultrasound Laboratory, Estácio de Sá University, Rio de Janeiro, Brazil. Electronic address: cbmfisio@gmail.com.
authors.forename: Christiano Bittencourt
authors.initials: CB
authors.lastname: Machado
authors.affiliation: LabTau, Unité Inserm1032, 141 Cours Albert Thomas, Lyon 69003, France. Electronic address: frederic.pad@gmail.com.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Padilla
authors.affiliation: Biomedical Engineering Program, COPPE/Federal University of Rio de Janeiro, RJ, Brazil. Electronic address: wagner.coelho@ufrj.br.
authors.forename: Wagner Coelho de Albuquerque
authors.initials: WC
authors.lastname: Pereira
mesh_terms: D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
keywords: Discriminant analysis; Liver fibrosis; Ultrasound