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ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1457960
This article is part of the Research Topic Bridging the Gap: Current Clinical Practices for Metabolic Dysfunction-Associated Steatotic Liver Disease View all 5 articles
Inter-and Intraobserver Variability of Attenuation Coefficient Measurement (ACM) in Innovative Ultrasound Diagnosis of Metabolic Dysfunction-Associated Steatotic Liver Disease: a Cross-Sectional Study
Provisionally accepted
Maksym Zhaivoronok 1 Oleh Dynnyk 2 Olexandr Livkutnyk 3 Viktoriia Yerokhovych 4 Violetta Yuzvenko 5 Iryna Serednia 4 Yelizaveta Melnychenko 4
Nazarii Kobyliak 4*- 1 P. L. Shupyk National University of Health Care of Ukraine, Kyiv, Ukraine
- 2 Other, Kyiv, Ukraine
- 3 Kyiv City Clinical Endocrinology Center, Kyiv, Ukraine
- 4 Bogomolets National Medical University, Kyiv, Ukraine
- 5 Ukrainian Research and Practical Centre of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv, Ukraine
Introduction: Evaluation of the ultrasound attenuation coefficient is widely used in the diagnosis of steatotic liver disease (SLD). US steatometry with real-time attenuation coefficient measurement (ACM) is an imaging tool that can replace and surpass the B-mode and improve the noninvasive diagnosis of SLD.Aim: To evaluate the intra- and interobserver variability of ACM for the assessment of SLD.Material and methods: A single-center cross-sectional study was conducted at the Kyiv City Clinical Endocrinology Center. We examined 52 patients (25 men and 27 women) with a mean age of 53.2±4.73 years. B-mode and ACM were performed on a Soneus P7 US system (Ultrasign, Ukraine). Examinations were performed by 2 radiologists with 28 (expert 1) and 17 (expert 2) years of experience and 4 general practitioners (GPs) without US experience (nonexperts 1-4). The training of 4 GPs on mastering the ACM was only 60 minutes due to US steatophantom. Each doctor performed 5 measurements of the ACM for each patient. The inter- and intraobserver variability of the results was determined by using an intraclass correlation coefficient (ICC) with a 95% confidence interval (95% CI).Results: The overall intraobserver variability after 5 days of examination was as follows: for expert 1 - 0.958 (95% CI 0.938-0.974); for expert 2 - 0.936 (95% CI 0.905-0.980); nonexpert 1 - 0.891 (95% CI 0.843-0.929); nonexpert 2 - 0.915 (95% CI 0.876-0.945); nonexpert 3 - 0.927 (95% CI 0.893-0.953); nonexpert 4 - 0.880 (95% CI 0.827-0.927). Interobserver variability at the final timepoint (day 5) was as follows: between experts 1 and 2, 0.942 (95% CI 0.898-0.967); between nonexperts 1-4 overall, 0.871 (95% CI 0.800-0.921); and overall, 0.922 (95% CI 0.883-0.951).Conclusions: Real-time US steatometry with ACM measurement is an informative, simple method with excellent intra- and interobserver variability and a reproducible method for population assessment for the early diagnosis and staging of SLD. The simplicity of ACM technology allows general practitioners to master the technique within 60 minutes. ACM measurements can be effectively employed by general practitioners (GPs) for population screening, enabling timely identification and management of MASLD.
Keywords: interobserver and intraobserver variability, attenuation coefficient (AC), Steatometry, Steatotic liver disease (SLD), Metabolic dysfunction-associated steatotic liver disease
Received: 01 Jul 2024; Accepted: 28 Feb 2025.
Copyright: © 2025 Zhaivoronok, Dynnyk, Livkutnyk, Yerokhovych, Yuzvenko, Serednia, Melnychenko and Kobyliak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Nazarii Kobyliak, Bogomolets National Medical University, Kyiv, Ukraine
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