{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:09:32Z","timestamp":1793171372565,"version":"4.5.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Methods for measuring the ultrasound attenuation coefficient (AC) vary across different systems. Some have fixed regions of interest (ROI) while others have movable ROIs. Aims were to evaluate whether, using a system with a fixed ROI, correlation between AC and MRI proton density fat fraction (MRI-PDFF), and performance could be improved by (i) reducing fixed ROI length to 30\u2009mm, changing starting point from the transducer, and (ii) using a movable ROI at different depths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this retrospective multicenter study, AC measurements were performed with the Arietta 850 system, and raw data were automatically stored. AC values were obtained using a standard commercial algorithm (ROI-setting1, 35\u201375\u2009mm from transducer). Raw data were successively reprocessed externally using a fixed 45\u201375\u2009mm ROI (ROI-setting2) and a movable 30\u2009mm ROI positioned with the top at 20\u2009mm (ROI-setting3) and 25\u2009mm below the liver capsule (ROI-setting4). Spearman rho and area under the receiver operating characteristics curve (AUROC) were used to assess correlation with MRI-PDFF and performance, respectively, and the Delong test was used to compare AUROCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven hundred fifty participants (median age: 65 [52, 73] years; 384 males) were included. Correlation of ROI-setting1 with MRI-PDFF was 0.75 (0.72, 0.78), reaching 0.80 (0.77, 0.82) with ROI-setting4. Overall, ROI-setting4 showed significantly\u00a0the best performance across steatosis grades. AUROCs for\n                      <jats:italic>S<\/jats:italic>\n                      \u2009&gt;\u20090 were 0.90 (0.87, 0.92) for ROI-setting1 and 0.92 (0.90, 0.94) with ROI-setting4 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). This latter performed significantly better than all other settings in participants with obesity and skin-to-liver distance\u2009&gt;\u200925\u2009mm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A movable ROI improves both AC correlation with MRI-PDFF and performance. The highest improvement was with the ROI top 25\u2009mm below the liver capsule.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>It remains uncertain whether utilizing an ROI at a fixed position from the transducer is optimal for ultrasound AC measurements<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>The highest AC performance and correlation with MRI-PDFF were observed with a movable ROI positioned with the top at 25\u2009mm under the liver capsule<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>A movable ROI with consistent sub-capsular placement improves both correlation between AC and MRI-PDFF, as well as its performance, whereas in individuals with a skin-to-liver capsule distance\u2009&gt;\u200925\u2009mm, a fixed ROI position significantly decreases AC performance<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-11906-5","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T08:13:47Z","timestamp":1757060027000},"page":"1853-1863","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Optimization of measurements with an ultrasound attenuation coefficient algorithm for quantifying liver fat"],"prefix":"10.1007","volume":"36","author":[{"given":"Giovanna","family":"Ferraioli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Roccarina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kumada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadanobu","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Hirooka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8021-0072","authenticated-orcid":false,"given":"Richard G.","family":"Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"11906_CR1","doi-asserted-by":"publisher","first-page":"3402","DOI":"10.1038\/s41591-024-02958-z","volume":"30","author":"JV Lazarus","year":"2024","unstructured":"Lazarus JV, Ivancovsky Wajcman D, Mark HE et al (2024) Opportunities and challenges following approval of resmetirom for MASH liver disease. 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EClinicalMedicine 51:101547","journal-title":"EClinicalMedicine"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-025-11906-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00330-025-11906-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-025-11906-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T13:20:49Z","timestamp":1772716849000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00330-025-11906-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["11906"],"URL":"https:\/\/doi.org\/10.1007\/s00330-025-11906-5","relation":{},"ISSN":["1432-1084"],"issn-type":[{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]},"assertion":[{"value":"22 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantors of this publication are Giovanna Ferraioli and Richard G Barr.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"G.F. has received a speaker honorarium from Canon Medical Systems, Esaote SpA, Fujifilm, Mindray Bio-Medical Electronics Co., Philips Healthcare, and Siemens Healthineers. She has served as a consultant to Philips Healthcare, and her university has received unrestricted research grants from Canon Medical Systems, Esaote SpA, and ultrasound equipment grants from Canon Medical Systems, Esaote SpA, Fujifilm Medical Systems, and Philips Ultrasound. She is on the Scientific Editorial Board of\n                      European Radiology\n                      (section editor: ultrasound); as such, she did not participate in the selection or review processes for this article. RGB has received research grants or equipment support from Siemens Healthineers, Philips Ultrasound, Samsung Medison, Mindray Bio-Medical Electronics, Canon Medical Systems, FujiFilm, and SuperSonic Imagine; payment or honoraria for speakers\u2019 bureaus from Philips Ultrasound, Samsung Medison, Canon Medical Systems, Siemens Healthineers, SuperSonic Imagine, and Mindray; travel support for speakers' bureaus from Philips Ultrasound, Mindray, and SuperSonic Imagine. They are affiliated with Southwoods Imaging, OH, USA. The remaining authors declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Davide Roccarina, who is one of the authors, has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects (patients) in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Some study subjects or cohorts have been previously reported in two articles [\n                      \n                      ,\u2009\n                      \n                      ]. It has been declared in M&M.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}