Abstract | BACKGROUND & AIMS: The ultrasound-based controlled attenuation parameter (CAP) is a non-invasive tool widely validated for assessing liver steatosis across different etiologies. However, few studies, with liver biopsy available, have investigated its performance in individuals with morbid obesity. Herein, we aimed to evaluate the diagnostic accuracy of CAP in participants with morbid obesity from the MAFALDA study before bariatric surgery. METHODS: A total of 120 individuals with valid examinations within three months from bariatric surgery were included. Clinical, laboratory, FibroScan® (XL probe), and liver biopsy data were collected using standardized procedures. The overall accuracy of CAP for detecting liver steatosis was estimated by the area under the receiver-operating characteristics curve (AUROC). Optimal cut-offs were chosen at points with the highest Youden index. RESULTS: The AUROCs of CAP for detecting S ≥ S1, S ≥ S2, and S = S3 were 0.91 (95% CI 0.86-0.97), 0.83 (95% CI 0.76-0.90), and 0.86 (95% CI 0.79-0.94), respectively. The best CAP cut-offs for S ≥ S1, S ≥ S2, and S = S3 were 300 dB/m (95% CI 275-316), 328 dB/m (95% CI 296-345), and 344 dB/m (95% CI 343-352), respectively. CAP values were independently influenced by steatosis grade (estimate 20.60, 95% CI 12.70-28.40, P = 1.05 × 10-6 ). The AUROC of FibroScan-AST (FAST) score for detecting progressive non- alcoholic steatohepatitis was 0.76 (95% CI 0.66-0.86). CONCLUSIONS: In individuals with morbid obesity, CAP measured by XL probe is an accurate non-invasive tool for grading liver steatosis. Measurement of liver fat content by CAP may help identify those eligible for bariatric procedures and estimate the effect of bariatric surgery on hepatic steatosis. LAY SUMMARY:
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Authors | Federica Tavaglione, Antonio De Vincentis, Vincenzo Bruni, Ida Francesca Gallo, Simone Carotti, Dario Tuccinardi, Giuseppe Spagnolo, Ester Ciociola, Rosellina Margherita Mancina, Oveis Jamialahmadi, Rossella D'Alessio, Bruna Bottazzi, Silvia Manfrini, Antonio Picardi, Giuseppe Perrone, Paolo Pozzilli, Marco Caricato, Umberto Vespasiani-Gentilucci, Stefano Romeo |
Journal | Liver international : official journal of the International Association for the Study of the Liver
(Liver Int)
Vol. 42
Issue 2
Pg. 374-383
(02 2022)
ISSN: 1478-3231 [Electronic] United States |
PMID | 34890093
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2021 The Authors. Liver International published by John Wiley & Sons Ltd. |
Topics |
- Bariatric Surgery
- Biopsy
- Elasticity Imaging Techniques
(methods)
- Humans
- Liver
(diagnostic imaging, pathology)
- Non-alcoholic Fatty Liver Disease
(complications, diagnostic imaging, pathology)
- Obesity, Morbid
(complications, surgery)
- ROC Curve
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