The clinical value of Controlled Attenuation Parameter (CAP) for the noninvasive assessment of liver steatosis

2016 Liver International In press;

BACKGROUND & AIMS: Ultrasound is the imaging modality most widely utilized in the general population for diagnostic purposes. Controlled Attenuation Parameter is a novel non-invasive method for assessing steatosis. Our aim was to investigate whether the clinical value of Controlled Attenuation Parameter in patients referred for abdominal ultrasound examinations is affected by liver fibrosis. METHODS: Consecutive patients referred for abdominal ultrasound examinations were enrolled. Controlled Attenuation Parameter and liver stiffness were assessed with the FibroScan (Echosens, France). Liver fibrosis was staged according to published cutoffs of liver stiffness measurements. Pearson's or Spearman's rank correlation coefficient were used to test the association between two study variables. Optimal cutoff of Controlled Attenuation Parameter for diagnosing liver steatosis (S>/=2) was 256 dB/m. The diagnostic performance and accuracy of dichotomized Controlled Attenuation Parameter, ultrasound, and body mass index were analyzed using the imperfect gold standard methodology. RESULTS: 726 subjects (464 males and 262 females) were studied. 589 patients (81.1%) were affected by chronic viral hepatitis. Correlation of Controlled Attenuation Parameter with ultrasound score was 0.48 and 0.57 in patients with and without chronic viral hepatitis, respectively. In patients with chronic viral hepatitis ultrasound, dichotomized Controlled Attenuation Parameter, body mass index showed performance of 58.2%, 82.3%, 46.7%, respectively, whereas in patients without hepatitis the performance was 86.4%, 68.6%, 48.6%, respectively. CONCLUSIONS: In patients with chronic viral hepatitis and advanced liver fibrosis Controlled Attenuation Parameter performs better than ultrasound for assessing liver steatosis, whereas in patients without liver disease ultrasound shows the best performance. This article is protected by copyright. All rights reserved.

Pubmed : 27439331