BACKGROUND Hepatic steatosis,characterized by fat accumulation in hepatocytes,can result from metabolic dysfunction-associated steatotic liver disease(MASLD),infections,alcoholism,chemotherapy,and toxins.MASLD is diag...BACKGROUND Hepatic steatosis,characterized by fat accumulation in hepatocytes,can result from metabolic dysfunction-associated steatotic liver disease(MASLD),infections,alcoholism,chemotherapy,and toxins.MASLD is diagnosed via imaging or biopsy with metabolic criteria and may progress to metabolic dysfunction–asso-ciated steatohepatitis,potentially leading to fibrosis,cirrhosis,or cancer.The coexistence of hepatic steatosis with chronic hepatitis B(CHB)is mainly related to metabolic factors and increases mortality and cancer risks.As a noninvasive method,attenuation imaging(ATI)shows promise in quantifying liver fat,demonstrating strong correlation with liver biopsy.AIM To investigate the disparity of ATI for assessing biopsy-based hepatic steatosis in CHB patients and MASLD patients.METHODS The study enrolled 249 patients who underwent both ATI and liver biopsy,including 78 with CHB and 171 with MASLD.Hepatic steatosis was classified into grades S0 to S3 according to the proportion of fat cells present.Liver fibrosis was staged from 0 to 4 according to the meta-analysis of histological data in viral hepatitis scoring system.The diagnostic performance of attenuation coefficient(AC)values across different groups was compared for each grade of steatosis.Factors associated with the AC values were determined through linear regression analysis.A multivariate logistic regression model was established to predict≥S2 within the MASLD group.RESULTS In both the CHB and the MASLD groups,AC values increased significantly with higher steatosis grade(P<0.001).In the CHB group,the areas under the curve(AUCs)of AC for predicting steatosis grades≥S1,≥S2 and S3 were 0.918,0.960 and 0.987,respectively.In contrast,the MASLD group showed AUCs of 0.836,0.774,and 0.688 for the same steatosis grades.The diagnostic performance of AC for detecting≥S2 and S3 indicated significant differences between the two groups(both P<0.001).Multivariate linear regression analysis identified body mass index,trigly-cerides,and steatosis grade as significant factors for AC.When the steatosis grade is≥S2,it can progress to more serious liver conditions.A clinical model integrating blood biochemical parameters and AC was developed in the MASLD group to enhance the prediction of≥S2,achieving an AUC of 0.848.CONCLUSION The AC could effectively discriminate the degree of steatosis in both the CHB and MASLD groups.In the MASLD group,when combined with blood biochemical parameters,AC exhibited better predictive ability for moderate to severe steatosis.展开更多
Artificial intelligence(AI)is revolutionizing medical imaging,particularly in chronic liver diseases assessment.AI technologies,including machine learning and deep learning,are increasingly integrated with multiparame...Artificial intelligence(AI)is revolutionizing medical imaging,particularly in chronic liver diseases assessment.AI technologies,including machine learning and deep learning,are increasingly integrated with multiparametric ultrasound(US)techniques to provide more accurate,objective,and non-invasive evaluations of liver fibrosis and steatosis.Analyzing large datasets from US images,AI enhances diagnostic precision,enabling better quantification of liver stiffness and fat content,which are essential for diagnosing and staging liver fibrosis and steatosis.Combining advanced US modalities,such as elastography and doppler imaging with AI,has demonstrated improved sensitivity in identifying different stages of liver disease and distinguishing various degrees of steatotic liver.These advancements also contribute to greater reproducibility and reduced operator dependency,addressing some of the limitations of traditional methods.The clinical implications of AI in liver disease are vast,ranging from early detection to predicting disease progression and evaluating treatment response.Despite these promising developments,challenges such as the need for large-scale datasets,algorithm transparency,and clinical validation remain.The aim of this review is to explore the current applications and future potential of AI in liver fibrosis and steatosis assessment using multiparametric US,highlighting the technological advances and clinical relevance of this emerging field.展开更多
Plasmonic materials enable flexible optical manipulation owing to their unique plasmon resonance,making them highly promising for photoelectronic imaging attenuation.However,designing plasmonic materials capable of mu...Plasmonic materials enable flexible optical manipulation owing to their unique plasmon resonance,making them highly promising for photoelectronic imaging attenuation.However,designing plasmonic materials capable of multifaceted imaging attenuation remains challenging.This study theoretically designed and experimentally prepared a unique dual nonmetallic plasmonic Ti_(3)C_(2)T_(x)/TiN hybrid.The composite material exhibited excellent performance in multifrequency,active/passive,and polarized multifunctional imaging attenuation.TiN nanoclusters were chemically bonded to Ti_(3)C_(2)T_(x) nanosheets through an ultrasonic-assisted method to form a Ti_(3)C_(2)T_(x)/TiN hybrid.The strong nonmetallic plasmonic coupling within these hybrids enables superior absorption and excellent photothermal conversion.Consequently,MXene/TiN aerosols demonstrated an improvement of approximately 14%in imaging attenuation compared with traditional oil–water aerosols in visible-light imaging.In addition,the hybrid exhibited strong electromagnetic wave absorption,covering nearly the entire 8.96–18 GHz range.Moreover,polarization imaging attenuation improved by 8.3%compared with that of oil–water aerosols,as evidenced by algorithmically dehazed images.Furthermore,the material effectively provided“high-temperature thermal concealment”for far-infrared active imaging attenuation.This study paves the way for developing multifunctional imaging attenuation materials,with significant potential for future imaging attenuation technologies.展开更多
BACKGROUND Shear wave speed(SWS),shear wave dispersion(SWD),and attenuation imaging(ATI)are new diagnostic parameters for non-alcoholic fatty liver disease.To differentiate between non-alcoholic steatohepatitis(NASH)a...BACKGROUND Shear wave speed(SWS),shear wave dispersion(SWD),and attenuation imaging(ATI)are new diagnostic parameters for non-alcoholic fatty liver disease.To differentiate between non-alcoholic steatohepatitis(NASH)and non-alcoholic fatty liver(NAFL),we developed a clinical index we refer to as the“NASH pentagon”consisting of the 3 abovementioned parameters,body mass index(BMI),and Fib-4 index.AIM To investigate whether the area of the NASH pentagon we propose is useful in discriminating between NASH and NAFL.METHODS This non-invasive,prospective,observational study included patients diagnosed with fatty liver by abdominal ultrasound between September 2021 and August 2022 in whom shear wave elastography,SWD,and ATI were measured.Histological diagnosis based on liver biopsy was performed in 31 patients.The large pentagon group(LP group)and the small pentagon group(SP group),using an area of 100 as the cutoff,were compared;the NASH diagnosis rate was also investigated.In patients with a histologically confirmed diagnosis,receiveroperating characteristic(ROC)curve analyses were performed.RESULTS One hundred-seven patients(61 men,46 women;mean age 55.1 years;mean BMI 26.8 kg/m2)were assessed.The LP group was significantly older(mean age:60.8±15.2 years vs 46.4±13.2 years;P<0.0001).Twenty-five patients who underwent liver biopsies were diagnosed with NASH,and 6 were diagnosed with NAFL.On ROC curve analyses,the areas under the ROC curves for SWS,dispersion slope,ATI value,BMI,Fib-4 index,and the area of the NASH pentagon were 0.88000,0.82000,0.58730,0.63000,0.59333,and 0.93651,respectively;the largest was that for the area of the NASH pentagon.CONCLUSION The NASH pentagon area appears useful for discriminating between patients with NASH and those with NAFL.展开更多
The incidence of nonalcoholic fatty liver disease(NAFLD),a common chronic liver disease,is increasing yearly.With increasing degrees of liver steatosis,NAFLD can progress to varying degrees of hepatic fibrosis,cirrhos...The incidence of nonalcoholic fatty liver disease(NAFLD),a common chronic liver disease,is increasing yearly.With increasing degrees of liver steatosis,NAFLD can progress to varying degrees of hepatic fibrosis,cirrhosis,and even hepatocellular carcinoma(HCC),with a concomitant increase in the risk of metabolic syndrome and cardiovascular disease.Therefore,early diagnosis and accurate assessment of NAFLD are particularly significant.Although liver biopsy is regarded as the standard for evaluating the degree of hepatic steatosis in NAFLD,it is not frequently utilized due to its invasiveness.Ultrasound technology as a noninvasive diagnostic method has the advantages of operating simplicity and economy.It can effectively diagnose and assess the disease of NAFLD.This article mainly summarizes the current status and progress of research on the assessment of NAFLD and liver steatosis by two main types of ultrasound techniques,semi-quantitative and quantitative ultrasound,as well as other emerging techniques,and briefly describes the strengths and limitations of B-mode ultrasound,controlled attenuation parameters(CAP),and attenuation imaging(ATI)in this field.展开更多
基金Supported by the National Natural Science Foundation of China,No.82202185and Shanghai Science and Technology Development Foundation,No.22Y11911500.
文摘BACKGROUND Hepatic steatosis,characterized by fat accumulation in hepatocytes,can result from metabolic dysfunction-associated steatotic liver disease(MASLD),infections,alcoholism,chemotherapy,and toxins.MASLD is diagnosed via imaging or biopsy with metabolic criteria and may progress to metabolic dysfunction–asso-ciated steatohepatitis,potentially leading to fibrosis,cirrhosis,or cancer.The coexistence of hepatic steatosis with chronic hepatitis B(CHB)is mainly related to metabolic factors and increases mortality and cancer risks.As a noninvasive method,attenuation imaging(ATI)shows promise in quantifying liver fat,demonstrating strong correlation with liver biopsy.AIM To investigate the disparity of ATI for assessing biopsy-based hepatic steatosis in CHB patients and MASLD patients.METHODS The study enrolled 249 patients who underwent both ATI and liver biopsy,including 78 with CHB and 171 with MASLD.Hepatic steatosis was classified into grades S0 to S3 according to the proportion of fat cells present.Liver fibrosis was staged from 0 to 4 according to the meta-analysis of histological data in viral hepatitis scoring system.The diagnostic performance of attenuation coefficient(AC)values across different groups was compared for each grade of steatosis.Factors associated with the AC values were determined through linear regression analysis.A multivariate logistic regression model was established to predict≥S2 within the MASLD group.RESULTS In both the CHB and the MASLD groups,AC values increased significantly with higher steatosis grade(P<0.001).In the CHB group,the areas under the curve(AUCs)of AC for predicting steatosis grades≥S1,≥S2 and S3 were 0.918,0.960 and 0.987,respectively.In contrast,the MASLD group showed AUCs of 0.836,0.774,and 0.688 for the same steatosis grades.The diagnostic performance of AC for detecting≥S2 and S3 indicated significant differences between the two groups(both P<0.001).Multivariate linear regression analysis identified body mass index,trigly-cerides,and steatosis grade as significant factors for AC.When the steatosis grade is≥S2,it can progress to more serious liver conditions.A clinical model integrating blood biochemical parameters and AC was developed in the MASLD group to enhance the prediction of≥S2,achieving an AUC of 0.848.CONCLUSION The AC could effectively discriminate the degree of steatosis in both the CHB and MASLD groups.In the MASLD group,when combined with blood biochemical parameters,AC exhibited better predictive ability for moderate to severe steatosis.
文摘Artificial intelligence(AI)is revolutionizing medical imaging,particularly in chronic liver diseases assessment.AI technologies,including machine learning and deep learning,are increasingly integrated with multiparametric ultrasound(US)techniques to provide more accurate,objective,and non-invasive evaluations of liver fibrosis and steatosis.Analyzing large datasets from US images,AI enhances diagnostic precision,enabling better quantification of liver stiffness and fat content,which are essential for diagnosing and staging liver fibrosis and steatosis.Combining advanced US modalities,such as elastography and doppler imaging with AI,has demonstrated improved sensitivity in identifying different stages of liver disease and distinguishing various degrees of steatotic liver.These advancements also contribute to greater reproducibility and reduced operator dependency,addressing some of the limitations of traditional methods.The clinical implications of AI in liver disease are vast,ranging from early detection to predicting disease progression and evaluating treatment response.Despite these promising developments,challenges such as the need for large-scale datasets,algorithm transparency,and clinical validation remain.The aim of this review is to explore the current applications and future potential of AI in liver fibrosis and steatosis assessment using multiparametric US,highlighting the technological advances and clinical relevance of this emerging field.
基金National Natural Science Foundation of China,Grant/Award Numbers:61871389,62304256College of Electronic Engineering,Grant/Award Numbers:KY21C220,KY22C213,KY24A204+2 种基金State Key Laboratory of Pulsed Power Laser Technology,Grant/Award Number:KY21C604Scientific Research Project of the National University of Defense Technology under Grant,Grant/Award Number:22-ZZCX-07Hefei Comprehensive National Science Center,Grant/Award Number:KY23C502。
文摘Plasmonic materials enable flexible optical manipulation owing to their unique plasmon resonance,making them highly promising for photoelectronic imaging attenuation.However,designing plasmonic materials capable of multifaceted imaging attenuation remains challenging.This study theoretically designed and experimentally prepared a unique dual nonmetallic plasmonic Ti_(3)C_(2)T_(x)/TiN hybrid.The composite material exhibited excellent performance in multifrequency,active/passive,and polarized multifunctional imaging attenuation.TiN nanoclusters were chemically bonded to Ti_(3)C_(2)T_(x) nanosheets through an ultrasonic-assisted method to form a Ti_(3)C_(2)T_(x)/TiN hybrid.The strong nonmetallic plasmonic coupling within these hybrids enables superior absorption and excellent photothermal conversion.Consequently,MXene/TiN aerosols demonstrated an improvement of approximately 14%in imaging attenuation compared with traditional oil–water aerosols in visible-light imaging.In addition,the hybrid exhibited strong electromagnetic wave absorption,covering nearly the entire 8.96–18 GHz range.Moreover,polarization imaging attenuation improved by 8.3%compared with that of oil–water aerosols,as evidenced by algorithmically dehazed images.Furthermore,the material effectively provided“high-temperature thermal concealment”for far-infrared active imaging attenuation.This study paves the way for developing multifunctional imaging attenuation materials,with significant potential for future imaging attenuation technologies.
文摘BACKGROUND Shear wave speed(SWS),shear wave dispersion(SWD),and attenuation imaging(ATI)are new diagnostic parameters for non-alcoholic fatty liver disease.To differentiate between non-alcoholic steatohepatitis(NASH)and non-alcoholic fatty liver(NAFL),we developed a clinical index we refer to as the“NASH pentagon”consisting of the 3 abovementioned parameters,body mass index(BMI),and Fib-4 index.AIM To investigate whether the area of the NASH pentagon we propose is useful in discriminating between NASH and NAFL.METHODS This non-invasive,prospective,observational study included patients diagnosed with fatty liver by abdominal ultrasound between September 2021 and August 2022 in whom shear wave elastography,SWD,and ATI were measured.Histological diagnosis based on liver biopsy was performed in 31 patients.The large pentagon group(LP group)and the small pentagon group(SP group),using an area of 100 as the cutoff,were compared;the NASH diagnosis rate was also investigated.In patients with a histologically confirmed diagnosis,receiveroperating characteristic(ROC)curve analyses were performed.RESULTS One hundred-seven patients(61 men,46 women;mean age 55.1 years;mean BMI 26.8 kg/m2)were assessed.The LP group was significantly older(mean age:60.8±15.2 years vs 46.4±13.2 years;P<0.0001).Twenty-five patients who underwent liver biopsies were diagnosed with NASH,and 6 were diagnosed with NAFL.On ROC curve analyses,the areas under the ROC curves for SWS,dispersion slope,ATI value,BMI,Fib-4 index,and the area of the NASH pentagon were 0.88000,0.82000,0.58730,0.63000,0.59333,and 0.93651,respectively;the largest was that for the area of the NASH pentagon.CONCLUSION The NASH pentagon area appears useful for discriminating between patients with NASH and those with NAFL.
基金This work was partially supported by grants from the National Natural Science Foundation of China(No.12071458).
文摘The incidence of nonalcoholic fatty liver disease(NAFLD),a common chronic liver disease,is increasing yearly.With increasing degrees of liver steatosis,NAFLD can progress to varying degrees of hepatic fibrosis,cirrhosis,and even hepatocellular carcinoma(HCC),with a concomitant increase in the risk of metabolic syndrome and cardiovascular disease.Therefore,early diagnosis and accurate assessment of NAFLD are particularly significant.Although liver biopsy is regarded as the standard for evaluating the degree of hepatic steatosis in NAFLD,it is not frequently utilized due to its invasiveness.Ultrasound technology as a noninvasive diagnostic method has the advantages of operating simplicity and economy.It can effectively diagnose and assess the disease of NAFLD.This article mainly summarizes the current status and progress of research on the assessment of NAFLD and liver steatosis by two main types of ultrasound techniques,semi-quantitative and quantitative ultrasound,as well as other emerging techniques,and briefly describes the strengths and limitations of B-mode ultrasound,controlled attenuation parameters(CAP),and attenuation imaging(ATI)in this field.
