Open AccessOptimal cutoff value for assessing changes in intrahepatic fat amount by using the controlled attenuation parameter in a longitudinal setting
Author(s) -
Sang Bong Ahn,
Dae Won Jun,
Bo-Kyeong Kang,
Mimi Kim,
Misoo Chang,
Eunwoo Nam
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000013636
Subject(s) - medicine , cutoff , magnetic resonance imaging , steatosis , nuclear medicine , receiver operating characteristic , nonalcoholic fatty liver disease , correlation , transient elastography , fatty liver , gastroenterology , radiology , cirrhosis , disease , liver fibrosis , physics , geometry , mathematics , quantum mechanics
The controlled attenuation parameter (CAP) has shown a good correlation with the intrahepatic fat amount in cross-sectional studies. However, there is no study on whether the change of CAP scores can also show good correlation in a longitudinal setting. Therefore, we investigated the correlation between CAP and magnetic resonance imaging-estimated proton density fat fraction (MR PDFF) through serial examination in a longitudinal setting. Sixty-five patients with nonalcoholic fatty liver disease were evaluated with MR PDFF and transient elastography including CAP at baseline and 3 months later. The CAP and MR PDFF at baseline showed a strong correlation in assessing hepatic steatosis (r = 0.66, P < .001). After treatment, the correlation between the change in CAP after treatment and the intrahepatic fat change (%) on MR PDFF was not satisfactory (r = 0.37, P = .005) in the longitudinal setting. The optimal cutoff value of the change in CAP for discriminating an improvement or an aggravation in intrahepatic fat percentage (>1% change in MR PDFF) was selected as 38 dB/m (area under the receiver operating characteristic curve = 0.559). For CAP changes > 38 dB/m, the predictive value was 14/16 (87.5%), whereas for changes < 38 dB/m, the predictive value was 12/41 (29.3%). Thereby, the accuracy of the method using the change in CAP was only 26/57 (46%). In addition, Cohen's kappa value was not significant (κ=0.11, P = .186). Careful interpretation of the steatosis change based on the CAP score is needed when the absolute change value is < 38 dB/m in a longitudinal setting.