{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:03:05Z","timestamp":1792504985366,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the performance of 3 ultrasound\u2010based liver fat quantification algorithms\u2014tissue attenuation imaging (TAI), tissue scatter imaging (TSI; Nakagami parameter), and ultrasound\u2010derived fat fraction (USFF)\u2014using magnetic resonance imaging\u2010derived proton density fat fraction (MRI\u2010PDFF) as the reference standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, IRB\u2010approved, HIPAA\u2010compliant study conducted at 2 North American centers, adults with or at risk for hepatic steatosis underwent quantitative ultrasound and same\u2010day MRI\u2010PDFF. The US examinations were performed with the Samsung RS85 system (Samsung Medison, Seoul, South Korea) using a C1\u20105S transducer. The software version utilized was 2.08.01.3538. Correlations were assessed using Spearman's rho. Diagnostic performance for steatosis grades S\u2009&gt;\u20090, S\u2009&gt;\u20091, and S\u2009&gt;\u20092 was evaluated using AUROC analysis. Overall accuracy across grades was also assessed with the Obuchowski measure. Correlations and AUROCs were compared using Steiger's and DeLong's tests, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 181 participants (113 women; median age, 57\u2009years), MRI\u2010PDFF correlated strongly with TAI and USFF (rho, 0.77 and 0.79) and moderately with TSI (rho, 0.57). For S\u2009&gt;\u20090, AUROCs were 0.92 for TAI, 0.78 for TSI, and 0.93 for USFF; for S\u2009&gt;\u20091, 0.88, 0.77, and 0.89; and for S\u2009&gt;\u20092, 0.81, 0.73, and 0.83, respectively. Obuchowski measures were 0.87, 0.76, and 0.88. TAI and USFF were significantly more accurate than TSI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.03 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.02), with no significant difference between them (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.79).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TAI and USFF showed high, comparable performance for detecting hepatic steatosis and outperformed TSI. USFF was numerically superior to TAI, without significant incremental benefit. Discrimination between moderate and severe steatosis remained limited in the US evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.70484","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:14:37Z","timestamp":1789791277000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic Accuracy of Quantitative Ultrasound Liver Fat Estimation with\n                    <scp>MRI<\/scp>\n                    \u2010\n                    <scp>PDFF<\/scp>\n                    as the Reference Standard"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1224-5502","authenticated-orcid":false,"given":"Davide","family":"Roccarina","sequence":"first","affiliation":[{"name":"UOC Medicina Interna e Gastroenterologia Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Sheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health Royal Free Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6344-697X","authenticated-orcid":false,"given":"Giovanna","family":"Ferraioli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Clinico\u2010Chirurgiche, Diagnostiche e Pediatriche University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2739-5972","authenticated-orcid":false,"given":"Ronald","family":"Hidalgo","sequence":"additional","affiliation":[{"name":"Department of Radiology Southern Illinois University School of Medicine, Springfield Clinic  Springfield Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8021-0072","authenticated-orcid":false,"given":"Richard G.","family":"Barr","sequence":"additional","affiliation":[{"name":"Department of Radiology Northeastern Ohio Medical University  Rootstown Ohio USA"},{"name":"Department of Radiology Southwoods Imaging  Youngstown Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/j.jhep.2023.04.036","article-title":"Changing epidemiology, global trends and implications for outcomes of NAFLD","volume":"79","author":"Wong VW","year":"2023","journal-title":"J Hepatol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.ultrasmedbio.2024.03.014","article-title":"WFUMB guidelines\/guidance on liver multiparametric ultrasound. Part 2: guidance on liver fat quantification","volume":"50","author":"Ferraioli G","year":"2024","journal-title":"Ultrasound Med Biol"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1148\/radiol.210736","article-title":"US attenuation for liver fat quantification: an AIUM\u2010RSNA QIBA pulse\u2010Echo quantitative ultrasound initiative","volume":"302","author":"Ferraioli G","year":"2022","journal-title":"Radiology"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.240162","article-title":"Intersystem and Interoperator agreement of US attenuation coefficient for quantifying liver steatosis","volume":"313","author":"Ferraioli G","year":"2024","journal-title":"Radiology"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.ultrasmedbio.2006.10.005","article-title":"Imaging local scatterer concentrations by the Nakagami statistical model","volume":"33","author":"Tsui PH","year":"2007","journal-title":"Ultrasound Med Biol"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","DOI":"10.1148\/rg.220181","article-title":"Liver fibrosis, fat, and iron evaluation with MRI and fibrosis and fat evaluation with US: a practical guide for radiologists","volume":"43","author":"Guglielmo FF","year":"2023","journal-title":"Radiographics"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.clinimag.2021.01.034","article-title":"Usefulness of US attenuation imaging for the detection and severity grading of hepatic steatosis in routine abdominal ultrasonography","volume":"76","author":"Kwon EY","year":"2021","journal-title":"Clin Imaging"},{"key":"e_1_2_8_9_1","first-page":"69","article-title":"Statistics corner: a guide to appropriate use of correlation coefficient in medical research","volume":"24","author":"Mukaka MM","year":"2012","journal-title":"Malawi Med J"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1037\/0033-2909.111.1.172","article-title":"Comparing correlated correlation coefficients","volume":"111","author":"Meng XL","year":"1992","journal-title":"Psychol Bull"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1161\/CIRCULATIONAHA.105.594929","article-title":"Receiver\u2010operating characteristic analysis for evaluating diagnostic tests and predictive models","volume":"115","author":"Zou KH","year":"2007","journal-title":"Circulation"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach","volume":"44","author":"DeLong ER","year":"1988","journal-title":"Biometrics"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3","article-title":"Index for rating diagnostic tests","volume":"3","author":"Youden WJ","year":"1950","journal-title":"Cancer"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/bimj.200410135","article-title":"Estimation of the Youden Index and its associated cutoff point","volume":"47","author":"Fluss R","year":"2005","journal-title":"Biom J"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"3261","DOI":"10.1002\/sim.944","article-title":"Assessing physicians' accuracy in diagnosing paediatric patients with acute abdominal pain: measuring accuracy for multiple diseases","volume":"20","author":"Obuchowski NA","year":"2001","journal-title":"Stat Med"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1373\/clinchem.2007.085795","article-title":"Standardization of ROC curve areas for diagnostic evaluation of liver fibrosis markers based on prevalences of fibrosis stages","volume":"53","author":"Poynard T","year":"2007","journal-title":"Clin Chem"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1373\/clinchem.2007.097923","article-title":"How to measure the diagnostic accuracy of noninvasive liver fibrosis indices: the area under the ROC curve revisited","volume":"54","author":"Lambert J","year":"2008","journal-title":"Clin Chem"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","DOI":"10.2214\/AJR.24.31709","article-title":"Quantitative ultrasound and ultrasound\u2010based elastography for chronic liver disease: practical guidance, from the AJR special series on quantitative imaging","volume":"225","author":"Zhang LX","year":"2025","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.3348\/kjr.2020.1262","article-title":"Quantitative ultrasound radiofrequency data analysis for the assessment of hepatic steatosis in nonalcoholic fatty liver disease using magnetic resonance imaging proton density fat fraction as the reference standard","volume":"22","author":"Jeon SK","year":"2021","journal-title":"Korean J Radiol"},{"key":"e_1_2_8_20_1","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.242564","article-title":"Metabolic dysfunction\u2010associated steatotic liver disease at quantitative US: international prospective study","volume":"316","author":"Huang TY","year":"2025","journal-title":"Radiology"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1148\/radiol.212808","article-title":"Pulse\u2010echo quantitative US biomarkers for liver steatosis: toward technical standardization","volume":"305","author":"Fetzer DT","year":"2022","journal-title":"Radiology"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0181789","article-title":"Effect of ultrasound frequency on the Nakagami statistics of human liver tissues","volume":"12","author":"Tsui PH","year":"2017","journal-title":"PLoS One"},{"key":"e_1_2_8_23_1","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1002\/jum.16048","article-title":"Interobserver variability in ultrasound\u2010based liver fat quantification","volume":"42","author":"\u015eendur HN","year":"2023","journal-title":"J Ultrasound Med"},{"key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/HEP.0000000000000895","article-title":"Ultrasound\u2010based steatosis grading system using 2D\u2010attenuation imaging: an individual patient data meta\u2010analysis with external validation","volume":"81","author":"Hobeika C","year":"2025","journal-title":"Hepatology"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.70484","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jum.70484","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.70484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:14:40Z","timestamp":1789791280000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.70484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":23,"alternative-id":["10.1002\/jum.70484"],"URL":"https:\/\/doi.org\/10.1002\/jum.70484","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"assertion":[{"value":"2026-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jum.70484"}}