Publications
The Quantitative Assessment of Hepatic Fat by Ultrasound Guided Attenuation Parameter in Comparison with MRI Proton Density Fat Fraction in Indian Adolescents
Shalini G. Hegde1 · Shreyas R. Kankara2 · Babu Philip2 · Roopashree C3 · Anura V. Kurpad4 · Pratibha Dwarkanath Metabolic dysfunction associated steatotic liver disease (MASLD) is an emerging concern in Indian children, and may occur even in the underweight [1]. While MRI proton density fat fraction (PDFF) is the most accurate non-invasive measurement of hepatic fat, it is impractical for large scale screening. Ultrasound guided attenuation parameter (UGAP) is more feasible but has not been validated in Indian children [2]. This cross-sectional study therefore, assessed the validity of UGAP against MRI-PDFF in apparently healthy adolescents. Exclusion criteria included hepatitis, recent major illness, metallic implants, or claustrophobia. MRI PDFF was acquired using an IDEAL-IQ sequence on a 3.0 T MRI [3] and UGAP (LOGIQ E10, GE) was performed by a single radiologist on the same day [4]. Forty children (35% boys) were recruited with a mean age of 14.3 ± 1.5 y. Of them, 72.5% had a normal BMI, 17.5% had thinness (BMI z score <-1) and 10% were overweight or obese (BMI z score >+1). The median (IQR) PDFF was 2.35% (2.10, 3.25%) while the mean ± SD UGAP was 0.54 ± 0.05 dB/cm/MHz. PDFF and UGAP were in complete agreement in detecting hepatic steatosis, which was present in 5% of participants. The correlation between UGAP and PDFF values was weak but statistically significant (Spearman Rho = 0.324, p = 0.041). UGAP’s portability, safety, ease-of-use and cost profile highlight its potential as a field-based screening methodto detect MASLD. The absence of sedation and minimal motion artefacts make it particularly suited for children. However, within normal hepatic fat ranges, UGAP showed weak correlation with PDFF, limiting its use for individual risk assessment. Higher correlations in previous studies likely reflect populations with more prevalent and severe steatosis. UGAP shows promise as a feasible screening tool for hepatic steatosis in low-resource pediatric settings, warranting validation in larger, diverse cohorts.
