Automated Measurement of Liver Attenuation to Identify Moderate-to-Severe Hepatic Steatosis from Chest CT Scans

Details

• Journal Article:
  Eur J Radiol
• Personal Author:
  Jirapatnakul, Artit ; Reeves, Anthony P. ; Lewis, Sara ; Chen, Xiangmeng ; Ma, Teng ; Yip, Rowena ; Chin, Xing ; Liu, Shuang ; Perumalswami, Ponni V. ; Yankelevitz, David F. ; Crane, Michael ; Branch, Andrea D. ; Henschke, Claudia I.
• Description:
  Purpose:
  
  Develop and validate an automated method for measuring liver attenuation in non-contrast low-dose chest CT (LDCT) scans and compare it to the standard manual method for identifying moderate-to-severe hepatic steatosis (HS).
  
  Method:
  
  The automated method identifies a region below the right lung within the liver and uses statistical sampling techniques to exclude non-liver parenchyma. The method was used to assess moderate-to-severe HS on two IRB-approved cohorts: 1) 24 patients with liver disease examined between 1/2013-1/2017 with non-contrast chest CT and abdominal MRI scans obtained within three months of liver biopsy, and 2) 319 lung screening participants with baseline LDCT performed between 8/2011-1/2017. Agreement between the manual and automated CT methods, the manual MRI method, and pathology for determining moderate-to-severe HS was assessed using Cohen’s Kappa by applying a 40 HU threshold to the CT method and 17.4% fat fraction to MRI. Agreement between the manual and automated CT methods was assessed using the intraclass correlation coefficient (ICC). Variability was assessed using Bland-Altman limits of agreement (LoA).
  
  Results:
  
  In the first cohort, the manual and automated CT methods had almost perfect agreement (ICC=0.97, κ=1.00) with LoA of −7.6—4.7 HU. Both manual and automated CT methods had almost perfect agreement with MRI (κ=0.90) and substantial agreement with pathology (κ=0.77). In the second cohort, the manual and automated CT methods had almost perfect agreement (ICC=0.94, κ = 0.87). LoA were −10.6—5.2 HU.
  
  Conclusion:
  
  Automated measurements of liver attenuation from LDCT scans can be used to identify moderate-to-severe HS on LDCT.
  
  
• Subjects:
  Fatty Liver Lung Magnetic Resonance Imaging Occupational Health Prospective Studies Reproducibility Of Results Safety Tomography, X-Ray Computed
• Keywords:
  Author Keywords: Hepatic Steatosis; Low-dose CT; Image Analysis; Lung Screening Medical Screening; Screening Methods; Medical Equipment; Scanning Techniques; Imaging Techniques; X-rays; Computers; Liver; Lung; Equipment Reliability; Performance Tests; Performance Capability; Measurement Equipment; Physiological Measurements; Automation; Manual Controls;
• Source:
  Eur J Radiol. 122:108723
• Pubmed ID:
  31778964
• Pubmed Central ID:
  PMC7179816
• Document Type:
  Text
• Funding:
  U01 OH011489/OH/NIOSH CDC HHS/United States
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  26 pdf pages
• Volume:
  122
• NIOSHTIC Number:
  nn:20059107
• Federal Fiscal Year:
  2020
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Collection(s):
  CDC Public Access National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b199b63c04638ae4e1bcde9b63edb829969dc9de753b780eccb50d2e51712751f201f5870d216bfcae058d39669e4002da32c135dd9ccffd4be7b9b768232ac0
• Download URL:
  https://stacks.cdc.gov/view/cdc/87165/cdc_87165_DS1.pdf
• File Type:
  [PDF - 2.09 MB ]