{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T18:18:10Z","timestamp":1780683490161,"version":"3.54.1"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose\u2002To assess the diagnostic performance of the normalized local variance (NLV) ultrasound technique in the detection of the fatty liver using histopathology as a reference standard.<\/jats:p><jats:p>\n          Materials and Methods\u2002We prospectively enrolled 194 consecutive patients with clinical suspicion of diffuse liver disease or history of liver transplantation. Conventional grayscale ultrasound and NLV examinations were performed and immediately followed by liver biopsies. The degrees of fatty liver, necroinflammatory activity, and fibrosis stage were evaluated by histopathological assessment. The diagnostic performance of the NLV values in detecting each grade of fatty liver was determined using receiver operating characteristics analyses, and multivariate linear regression analyses were performed to identify variables significantly associated with the NLV values.<\/jats:p><jats:p>\n          Results\u2002The number of patients in each degree of fatty liver and hepatic fibrosis was 118\/37\/26\/13 and 81\/68\/24\/6\/14 for none\/mild\/moderate\/severe steatosis and F0\u200a\/\u200aF1\/F2\u200a\/\u200aF3\/F4 fibrosis on histopathological examinations, respectively. The area under the receiver operating characteristics curve and optimal cut-off NLV value for detecting fatty liver of varying degrees were 0.911 and 1.095 for \u2265\u200aS1, 0.974 and 1.055 for \u2265\u200aS2, and 0.954 and 1.025 for \u2265\u200aS3, respectively. Multivariate analyses revealed that not fibrosis or inflammation but rather the degree of steatosis was associated with the NLV value.<\/jats:p><jats:p>\n          Conclusion\u2002The NLV value demonstrated excellent diagnostic performance for detecting varying degrees of fatty liver, and the degree of steatosis on histopathological examinations was the only significant factor affecting the NLV value.<\/jats:p>","DOI":"10.1055\/a-1143-3091","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T00:49:37Z","timestamp":1587602977000},"page":"599-606","source":"Crossref","is-referenced-by-count":12,"title":["Quantitative Assessment of Fatty Liver using Ultrasound with\u00a0Normalized Local Variance Technique"],"prefix":"10.1055","volume":"42","author":[{"given":"Jae Seok","family":"Bae","sequence":"additional","affiliation":[{"name":"Radiology, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Radiology, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Radiology, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haeryoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Pathology, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Jong","family":"Yu","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong-Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Ju","family":"Cho","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Bin","family":"Lee","sequence":"additional","affiliation":[{"name":"Internal Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Koo","family":"Han","sequence":"additional","affiliation":[{"name":"Radiology, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Ihn","family":"Choi","sequence":"additional","affiliation":[{"name":"Radiology, Chung Ang University Hospital, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,4,22]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1002\/hep.20466","article-title":"Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity","volume":"40","author":"J D Browning","year":"2004","journal-title":"Hepatology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1056\/NEJMra011775","article-title":"Nonalcoholic fatty liver disease","volume":"346","author":"P Angulo","year":"2002","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1038\/s41395-018-0088-6","article-title":"NASH Leading Cause of Liver Transplant in Women: Updated Analysis of Indications For Liver Transplant and Ethnic and Gender Variances","volume":"113","author":"M Noureddin","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"ref4","volume-title":"Fatty liver disease: NASH and related disorders","author":"G C Farrell","year":"2005"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.cld.2009.07.005","article-title":"Epidemiology and natural history of non-alcoholic steatohepatitis","volume":"13","author":"C K Argo","year":"2009","journal-title":"Clin Liver Dis"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1002\/hep.23594","article-title":"Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection","volume":"51","author":"B Q Starley","year":"2010","journal-title":"Hepatology"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.jhep.2015.02.045","article-title":"Hepatic steatosis and cardiovascular disease outcomes: An analysis of the Framingham Heart Study","volume":"63","author":"J L Mellinger","year":"2015","journal-title":"J\u00a0Hepatol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1056\/NEJMoa060326","article-title":"A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis","volume":"355","author":"R Belfort","year":"2006","journal-title":"N Engl J Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1056\/NEJMra1503519","article-title":"Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis","volume":"377","author":"A M Diehl","year":"2017","journal-title":"N Engl J Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1056\/NEJM200102153440706","article-title":"Liver biopsy","volume":"344","author":"A A Bravo","year":"2001","journal-title":"N Engl J Med"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1053\/j.gastro.2005.03.084","article-title":"Sampling variability of liver biopsy in nonalcoholic fatty liver disease","volume":"128","author":"V Ratziu","year":"2005","journal-title":"Gastroenterology"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1002\/hep.22742","article-title":"Liver biopsy","volume":"49","author":"D C Rockey","year":"2009","journal-title":"Hepatology"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1002\/hep.26455","article-title":"Utility of magnetic resonance imaging versus histology for quantifying changes in liver fat in nonalcoholic fatty liver disease trials","volume":"58","author":"M Noureddin","year":"2013","journal-title":"Hepatology"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3350\/cmh.2017.0042","article-title":"Imaging evaluation of non-alcoholic fatty liver disease: focused on quantification","volume":"23","author":"D H Lee","year":"2017","journal-title":"Clin Mol Hepatol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1259\/0007-1285-52-615-184","article-title":"Ultrasound in the detection of chronic liver disease (the \"bright liver\")","volume":"52","author":"A E Joseph","year":"1979","journal-title":"Br J Radiol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/S0168-8278(97)80288-7","article-title":"Noninvasive in vivo quantitative assessment of fat content in human liver","volume":"27","author":"C Ricci","year":"1997","journal-title":"J Hepatol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.jhep.2009.09.001","article-title":"Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study","volume":"51","author":"S Dasarathy","year":"2009","journal-title":"J Hepatol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"W320","DOI":"10.2214\/AJR.07.2123","article-title":"Interobserver and intraobserver variability in the sonographic assessment of fatty liver","volume":"189","author":"S Strauss","year":"2007","journal-title":"Am J Roentgenol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/j.jhep.2013.12.018","article-title":"Controlled attenuation parameter (CAP) for the diagnosis of steatosis: a prospective study of 5323 examinations","volume":"60","author":"V de Ledinghen","year":"2014","journal-title":"J Hepatol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1016\/j.ultrasmedbio.2010.07.005","article-title":"Controlled attenuation parameter (CAP): a novel VCTE guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes","volume":"36","author":"M Sasso","year":"2010","journal-title":"Ultrasound Med Biol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.jhep.2016.12.022","article-title":"Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis","volume":"66","author":"T Karlas","year":"2017","journal-title":"J Hepatol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1109\/T-SU.1978.30978","article-title":"Speckle in ultrasound B-mode scans","volume":"25","author":"C B Burckhardt","year":"1978","journal-title":"IEEE Trans Sonic Ultrason"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1109\/T-SU.1983.31404","article-title":"Statistics of speckle in ultrasound B-scans","volume":"30","author":"R F Wagner","year":"1983","journal-title":"IEEE Trans Sonic Ultrason"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/hep.20701","article-title":"Design and validation of a histological scoring system for nonalcoholic fatty liver disease","volume":"41","author":"D E Kleiner","year":"2005","journal-title":"Hepatology"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/hep.510240201","article-title":"An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group","volume":"24","author":"P Bedossa","year":"1996","journal-title":"Hepatology"},{"key":"ref27","first-page":"337","article-title":"Histological grading and staging of chronic hepatitis standardized guideline proposed by the Korean Study Group for the Pathology of Digestive Diseases","volume":"33","author":"Y N Park","year":"1999","journal-title":"Korean Journal of Pathology"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1046\/j.1467-789X.2002.00065.x","article-title":"Asians are different from Caucasians and from each other in their body mass index\/body fat per cent relationship","volume":"3","author":"P Deurenberg","year":"2002","journal-title":"Obes Rev"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1148\/radiol.2017161923","article-title":"Evaluation of Hepatic Steatosis by Using Acoustic Structure Quantification US in a Rat Model: Comparison with Pathologic Examination and MR Spectroscopy","volume":"285","author":"D H Lee","year":"2017","journal-title":"Radiology"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.2214\/AJR.07.4047","article-title":"B-mode ultrasound with algorithm based on statistical analysis of signals: evaluation of liver fibrosis in patients with chronic hepatitis C","volume":"193","author":"H Toyoda","year":"2009","journal-title":"Am J Roentgenol"}],"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1143-3091.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T23:48:34Z","timestamp":1638488914000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1143-3091"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,22]]},"references-count":29,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2021,12,2]]},"published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1143-3091","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"value":"0172-4614","type":"print"},{"value":"1438-8782","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,22]]}}}