Reliability of Hepatic Steatosis Quantification by Controlled Attenuation Parameter in Steatotic Liver Disease

作者：Lucie Simonis, Yannick Marcour, Jan Embacher, P Hruska, P J Andersen, Benedikt Mehl, Lorenz Balcar, Mathias Jachs, Michael Trauner, Aleksander Krag, Thomas Reiberger, Thomas-Matthias Scherzer, Mattias Mandorfer, Maja Thiele, Mette Lehmann, Georg Semmler · 发表于：Clinical Gastroenterology and Hepatology · 年份：2026 · DOI：10.1016/j.cgh.2026.05.006 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Nutrition and Health in Aging

BACKGROUND & AIMS: Assessment of hepatic steatosis is key for diagnosis and monitoring of steatotic liver disease. Controlled attenuation parameter is widely used, but concerns regarding its measurement variability exist. We evaluated the repeatability and reproducibility of controlled attenuation parameter and FibroScan-aspartate aminotransferase score across different clinical steatotic liver disease settings and disease stages. METHODS: We assessed same-day repeatability in subjects with suspected steatotic liver disease in secondary care (cohort I, n = 40) and tertiary care (cohort II, n = 58). Different-day reproducibility within 28 days was assessed in 4 cohorts: suspected steatotic liver disease (cohort III, n = 37), suspected fibrosis (cohort IV, n = 163), compensated advanced steatotic liver disease (cohort V, n = 32), and clinically significant portal hypertension (cohort VI, n = 28). Agreement was evaluated using the intraclass correlation coefficient, Bland-Altman analysis, and minimal detectable change. Categorical agreement was assessed by observed agreement and Cohen's Kappa. RESULTS: Same-day controlled attenuation parameter agreement was moderate to good (intraclass correlation coefficient, 0.64-0.80), but variability was substantial, with a minimal detectable change of 57 to 69 dB/m, corresponding to a relative minimal detectable change of 18% to 25%. Agreement for dichotomized controlled attenuation parameter cutoffs was moderate to strong (Cohen's Kappa = ...