Publications by authors named "Giovanna Ferraioli"

Background The extent of liver steatosis can be assessed using US attenuation coefficient (AC) algorithms currently implemented in several US systems. However, little is known about intersystem and interoperator variability in measurements. Purpose To assess intersystem and interoperator agreement in US AC measurements for fat quantification in individuals with varying degrees of liver steatosis and to assess the correlation of each manufacturer's AC algorithm results with MRI proton density fat fraction (PDFF).

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Background/objectives: Algorithms for quantifying liver fat content based on the ultrasound attenuation coefficient (AC) are currently available; however, little is known about whether their accuracy increases by applying quality criteria such as the interquartile range-to-median ratio (IQR/M) or whether the median or average AC value should be used.

Methods: AC measurements were performed with the Aplio i800 ultrasound system using the attenuation imaging (ATI) algorithm (Canon Medical Systems, Otawara, Tochigi, Japan). Magnetic resonance imaging proton density fat fraction (MRI-PDFF) was the reference standard.

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Chronic liver disease is a world-wide epidemic. Any etiology that causes inflammation in the liver will lead to chronic liver disease. Presently, the most common inciting factor worldwide is steatotic liver disease.

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Background Attenuation coefficient (AC) and shear-wave speed (SWS) are established US markers for assessing patients with metabolic dysfunction-associated steatotic liver disease (MASLD), while shear-wave dispersion slope (DS) is not. Purpose To assess the relationship between the multiparametric US imaging markers DS, AC, and SWS and liver histopathologic necroinflammation in patients with MASLD. Materials and Methods This international multicenter prospective study enrolled consecutive patients with biopsy-proven MASLD between June 2019 and March 2023.

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Article Synopsis
  • This study looked at two ways to measure how stiff the liver is, which helps doctors see if there is damage or disease in the liver.
  • They compared the results of these two methods, VCTE and ElastQ, using data from 840 people.
  • The findings showed that the differences in results got bigger as liver problems worsened, and some factors like BMI and distance between the skin and liver affected the measurements differently.
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It is known that in African countries the health condition is problematic, both from a diagnostic and therapeutic point of view. Patients have to travel long distances to access medical care. Many cannot afford the cost of transportation to a medical facility.

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Article Synopsis
  • The study investigates how the backscatter coefficient (BSC) in ultrasound measurements of the liver changes with depth, similar to how the attenuation coefficient (AC) does.
  • Using a Sequoia ultrasound system, researchers analyzed data from 104 individuals, adjusting for factors like age, sex, and skin-to-liver-capsule distance.
  • The results revealed that BSC decreases significantly with depth (around -13.98 dB/cm-steradian per cm), suggesting a need for a standardized protocol to improve measurement consistency and reliability over time.
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Article Synopsis
  • - The World Federation for Ultrasound in Medicine and Biology (WFUMB) has released an update on multiparametric ultrasound, specifically improving upon the 2018 Liver Elastography Guidelines with new findings related to chronic liver disease.
  • - The update employs the Oxford classification system to provide structured recommendations based on evidence levels, grades, and agreement among experts.
  • - Key topics include the use of shear wave elastography for assessing liver fibrosis and predicting disease outcomes, as well as guidelines for interpreting liver and spleen stiffness measurements in the context of portal hypertension.
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The World Federation for Ultrasound in Medicine and Biology (WFUMB) has promoted the development of this document on multiparametric ultrasound. Part 2 is a guidance on the use of the available tools for the quantification of liver fat content with ultrasound. These are attenuation coefficient, backscatter coefficient, and speed of sound.

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Article Synopsis
  • - This study conducts a meta-analysis to create a new grading system for liver steatosis using ultrasonography-based 2D-attenuation imaging (ATI), addressing the need for noninvasive tools in diagnosing liver disease.
  • - Eleven studies with 1374 patients revealed that ATI correlates strongly with histological and MRI-PDFF-confirmed steatosis, allowing for classification into four grades (S0 to S3) based on specific ATI measurements.
  • - The newly developed ATI grading system demonstrates high accuracy in determining liver steatosis, validated with independent patient cohorts and showing strong correlation with existing diagnostic methods.
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Objectives: To assess whether meal or water intake may affect the measurement of the ultrasound (US) attenuation coefficient (AC) imaging, a parameter that is directly related to liver fat content.

Methods: The study was performed in two centers (Italy and USA). AC was obtained using the ATI algorithm implemented in the Aplio i-series US systems (Canon Medical Systems, Japan) by one operator at each center.

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Article Synopsis
  • Noninvasive methods to assess liver fat content have become increasingly important due to the rising rates of steatosis.
  • Magnetic resonance techniques like MRS and MR chemical shift imaging are considered the reference standards for accurately quantifying liver fat.
  • Ultrasound can also estimate liver fat using various parameters, with the Controlled Attenuation Parameter being the first developed algorithm, and newer algorithms showing equal or improved accuracy.
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Quantitative MRI and ultrasound biomarkers of liver fibrosis have become important tools in the diagnosis and clinical management of children with chronic liver disease (CLD). In particular, MR elastography is now routinely performed in clinical practice to evaluate the liver for fibrosis. Ultrasound shear-wave elastography has also become widely performed for this purpose, especially in young children.

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Purpose: This study evaluated ElastQ, a two-dimensional shear wave elastography (2D-SWE) technique, for the non-invasive assessment of liver fibrosis risk using liver stiffness measurement (LSM). The aim was to determine its diagnostic accuracy and establish LSM cutoffs for clinical risk stratification.

Methods: A prospective multicenter study was conducted, employing vibration-controlled transient elastography (VCTE) as a reference standard.

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Purpose: This study's primary aim was to assess factors affecting ultrasound attenuation coefficient (AC) measurement repeatability using the Canon ultrasound (US) system. The secondary aim was to evaluate whether similar results were obtained with other vendors' AC algorithms.

Methods: This prospective study was performed at two centers from February to November 2022.

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Quantitative imaging biomarkers of liver disease measured by using MRI and US are emerging as important clinical tools in the management of patients with chronic liver disease (CLD). Because of their high accuracy and noninvasive nature, in many cases, these techniques have replaced liver biopsy for the diagnosis, quantitative staging, and treatment monitoring of patients with CLD. The most commonly evaluated imaging biomarkers are surrogates for liver fibrosis, fat, and iron.

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Objectives: The primary aim was to estimate the influence of various depths on ultrasound attenuation coefficient (AC) of multiple vendors in the liver. The secondary aim was to evaluate the impact of region of interest (ROI) size on AC measurements in a subset of participants.

Methods: This Institutional Review Board (IRB)-approved Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study was carried out in two centers using AC-Canon and AC-Philips algorithms and extracting AC-Siemens values from ultrasound-derived fat fraction algorithm.

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The diagnosis of liver fibrosis and the assessment of its severity are important to provide appropriate management, to determine the prognosis or the need for surveillance. Currently, for fibrosis staging, liver stiffness measurement (LSM) with the shear wave elastography (SWE) techniques is considered a reliable substitute for liver biopsy in several clinical scenarios. Nonetheless, it should be emphasized that stiffness value is a biomarker of diffuse liver disease that must be interpreted taking into consideration anamnesis, clinical and laboratory data.

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Background: The primary aim of our study was to assess the correlation between an improved version of the attenuation coefficient available on the Arietta 850 ultrasound system (iATT, Fujifilm Healthcare, Tokyo, Japan) and controlled attenuation parameter (CAP). The secondary aim was to assess whether focusing only on iATT acquisition without following the strict protocol for liver stiffness measurements would affect iATT measurement. Methods: Consecutive individuals were enrolled.

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