FATTY LIVER DISEASE: SOME CHALLENGES OF STEATOMETRY (REVIEW)

Introduction. The ultrasound hepatic steatometry is not only noninvasive, but also quite promising instrumental method for quantitative assessing and grading hepatic steatosis. However, there are some unclear aspects of this method. Aim. To compare the results of ultrasound hepatic steatometry for the quantitative assessment and grading of hepatic steatosis through a review of the research literature. Materials and methods. Using keywords (hepatic steatosis, ultrasound steatometry, ultrasound attenuation, liver disease, fatty liver disease, FibroScan, CAP score) the research articles were studied for the period 2010–2024 via the internet access service, most of all PubMed search platform. Results. It has been established that there is no generally accepted measurement for hepatic steatosis grades (S1, S2, S3) for FibroScan® (Echosens, France) and other ultrasound devices. At the same time, it was revealed that there is no generally accepted cut off for degrees of steatosis in scientific studies. Controlled attenuation parameter (CAP) for FibroScan® ultrasound apparatus was used to detect and quantify hepatic steatosis. CAP can be measured in dB/m using FibroScan S, M or XL probes with fixed scanning frequency (SF) in MHz. SF is very important for analyzing and comparing the results of different studies because it influences CAP. It is enough to indicate the probe, even without mentioning SF, in a research article to facilitate the understanding and comparison of results from different studies. Most researchers now mention the FibroScan probe used for steatometry, although some articles do not specify the probe. We found some articles about steatometry results (in dB/cm), where it was fulfilled for other ultrasound device without any information about SF in MHz. Although, it is known, that the frequency of waves emitted from ultrasound device during steatometry is very important for next analysis. Therefore, it is necessary to indicate the probe with fixed SF (S, M or XL) for FibroScan® investigation. For other ultrasound devices, the steatometry results should be recorded in units of dB/cm/MHz or dB/cm with the mandatory indication of the ultrasound wave frequency during steatometry in MHz. Conclusions. Taking into account the absence of universally accepted ultrasound cut off for the degrees of hepatic steatosis further studies are needed. They should have the same design with mandatory consideration of the frequency of the ultrasound probe for degrees of liver steatosis evaluation.