Early Detection of Liver Steatosis using Multiparametric Ultrasound Imaging

Nonalcoholic fatty liver disease (NAFLD) is common and includes a progression from steatosis, nonalcoholic steatohepatitis, to cirrhosis. Liver biopsy is the current standard for detecting the histologic features of NAFLD, but use is limited by invasiveness, sampling error, and potential complications. There is an ongoing need for the ability to noninvasively detect, accurately stage, and reliably monitor NAFLD in the clinical setting. To this end, we recently introduced an in vivo multiparametric ultrasound (mpUS) imaging approach to assess NAFLD. Our mpUS integrates contrast-enhanced ultrasound (US), shear wave elastography, and H-scan US measurements. In this paper, we further detail the use of mpUS imaging for the detection of early liver steatosis. Using rats fed either standard control chow (N = 4) or a methionine and choline deficient (MCD) diet (N = 6) that is known to induce liver steatosis, mpUS imaging was performed at baseline and again at 2 wk. Animals were then humanely euthanized and livers surgically removed for ex vivo analysis. Relative changes between baseline and 2 wk were analyzed and only the H-scan US measures in the MCD diet-fed animals were significantly different (p = 0.03). Histology confirmed liver steatosis in animals fed the MCD diet.