title: Multifeature analysis of an ultrasound quantitative diagnostic index for classifying nonalcoholic fatty liver disease.
abstract: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease related to metabolic syndrome. This study applied an integrated analysis based on texture, backscattering, and attenuation features in ultrasound imaging with the aim of assessing the severity of NAFLD. Ultrasound radiofrequency data obtained from 394 clinical cases were analyzed to extract three texture features (autocorrelation, sum average, and sum variance), the signal-to-noise ratio (SNR), and the slope of the center-frequency downshift (CFDS slope). The texture, SNR, and CFDS slope were combined to produce a quantitative diagnostic index (QDI) that ranged from 0 to 6. We trained the QDI using training data and then applied it to test data to assess its utility. In training data, the areas (AUCs) under the receiver operating characteristic curves for NAFLD and severe NAFLD were 0.81 and 0.84, respectively. In test data, the AUCs were 0.73 and 0.81 for NAFLD and severe NAFLD, respectively. The QDI was able to distinguish severe NAFLD and a normal liver from mild NAFLD, and it was significantly correlated with metabolic factors. This study explored the potential of using the QDI to supply information on different physical characteristics of liver tissues for advancing the ability to grade NAFLD.
authors.affiliation: Department of Biomedical Engineering, Hungkuang University, Taichung, 43302 Taiwan.
authors.forename: Yin-Yin
authors.initials: YY
authors.lastname: Liao
authors.affiliation: Department of Community and Family Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, 30059 Taiwan.|Department of Family Medicine, National Taiwan University Hospital Bei-Hu branch, Taipei, 10845 Taiwan.
authors.forename: Kuen-Cheh
authors.initials: KC
authors.lastname: Yang
authors.affiliation: Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, 30013 Taiwan.
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, 10048 Taiwan.|Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, 10671 Taiwan.
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Bei-Hu branch, Taipei, 10845 Taiwan.
authors.forename: Jin-De
authors.initials: JD
authors.lastname: Chen
authors.affiliation: Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, 30013 Taiwan.
authors.forename: Chih-Kuang
authors.initials: CK
authors.lastname: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D012372:ROC Curve; D012720:Severity of Illness Index; D059629:Signal-To-Noise Ratio; D014463:Ultrasonography / Q000379:methods; D055815:Young Adult