Beom Jin Park MD, Presenter: Nothing to Disclose

Sang Hoon Cha MD, Abstract Co-Author: Nothing to Disclose

Min Ju Kim MD, Abstract Co-Author: Nothing to Disclose

Deuk Jae Sung MD, Abstract Co-Author: Nothing to Disclose

Sung Bum Cho MD, Abstract Co-Author: Nothing to Disclose

Yu-Whan Oh MD, Abstract Co-Author: Nothing to Disclose

To assess the diagnostic accuracy of standard deviation (SD) measured by Image J (a public domain, Java-based image processing program) in hepatic fibrosis on ultrasound (US), comparing with liver stiffness measurement (LSM) by transient elastography (Fibroscan®) and pathology as a gold standard in chronic hepatitis B.

We enrolled 110 patients (53 of chronic Hepatitis B and 57 of normal control group), prospectively. All patients underwent a hepatic US with a 3–5 MHz transducer. Quantitative analysis of hepatic coarseness was automatically measured in average SD through Image J from four different regions–of–interest (ROIs) of the liver with all vessels, bile ducts, calcification, and artifact being avoided. LSM by Fibroscan®and liver biopsy was performed in all 53 patients with chronic hepatitis B, simultaneously. Liver parenchymal specimens by US–guided core needle biopsy were staged according to Ludwig classification for fibrosis. Diagnostic accuracy in texture analysis of hepatic echotexture by image J and LSM by Fibroscan® was assessed by ROC analysis.

The ranges of average SD by Image J and LSM in chronic hepatitis B were 10.6–23.5 (16.4±3.0) and 4.1–38.5 kPa (13.1±8.8), respectively. Average SD by Image J in each fibrosis stage (normal, F1, F2, F3, and F4) were 12.4±0.9, 14.2±2.3, 15.8±2.2, 16.9±2.8, and 19.6±1.9. And the mean values of LSM in each stage were 5.6±1.3, 10.0±6.2, 14.9±8.8, and 21.3±11.5 kPa. Average SD by Image J and LSM by Fibroscan® were well correlated with each fibrosis stages (r=0.62 and 0.68, P≤0.001). Area under the curve in average SD and LSM were 0.81 and 0.93 for F≥2; 0.84 and 0.81 for F≥3; 0.87 and 0.85 for F=4. Best diagnostic performance in average SD by Image J and LSM by Fibroscan® were shown in F≥2 with a relatively high hit ratio (89.2 and 86.8).

Average SD using Image J on US and LSM by Fibroscan® appears to be reliable for detection of significant fibrosis in chronic hepatitis B. Our preliminarily study using Image J shows the usefulness as objective diagnostic value of quantitative measurement of hepatic coarseness on US, although its diagnostic performance for each fibrosis stage is relatively low comparing with transient elastography.

Objective quantitative measurement of hepatic coarseness using Image J in chronic hepatitis B can be a feasible method for the diagnosis of significant fibrosis (≥F2).

Park, B, Cha, S, Kim, M, Sung, D, Cho, S, Oh, Y, Usefulness of Texture Analysis by Image J Program in Hepatic Parenchymal Echotexture: Prospective Comparison with Transient Elastography and Pathology  .  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014258.html