Noninvasive biomarkers in pediatric nonalcoholic fatty liver disease

Table 5 Imaging biomarkers for the detection of nonalcoholic fatty liver disease

Ref.	Marker	Country	Categories Tested	Sample size (n)	Dx	Cutoff	AUROC (95%CI)	Sens (%)	Spec (%)	PPV (%)	NPV (%)	P value
Yang et al[106], 2022	CAP [dB/m]	China	Predicting NAFL in with obesity	NAFLD (n = 61), Non-NAFLD (n = 59), NAFL (n = 44), NASH (n = 17)	US	> 262.5	0.659 (0.561-0.758)	59.1	60.5			0.0037
Yang et al[106], 2022	CAP [dB/m]	China	Predicting NAFL in with obesity	NAFLD (n = 61), Non-NAFLD (n = 59), NAFL (n = 44), NASH (n = 17)	US	> 258	0.757 (0.668-0.845)	67.2	67.2			<0.001
Chaidez et al[105], 2022	CAP [dB/m]	United States	S1-S3 vs S0	Total (n = 206), NAFLD (n = 116), Non-NAFLD (n = 90)	Biopsy	≥ 259	0.98 (0.96-0.99)	94	91	97	91
Yang et al[106], 2022	LSM [kPa]	China	Predicting NAFL in with obesity	NAFLD (n = 61), Non-NAFLD (n = 59), NAFL (n = 44), NASH (n = 17)	US	> 4.95	0.674 (0.577-0.771)	61.4	64.5			0.0015
Yang et al[106], 2022	LSM [kPa]	China	Predicting NAFL in with obesity	NAFLD (n = 61), Non-NAFLD (n = 59), NAFL (n = 44), NASH (n = 17)	US	> 4.65	0.768 (0.684-0.852)	70.5	70.7			< 0.001
Trout et al[134], 2018	MRE [kPa]	United States	NAFLD stage 0-1 vs ≥ stage 2 fibrosis in patients with steatosis	Total (n = 86), Ludwig ≥ stage 2 (n = 51), steatosis (n = 44)	Biopsy	2.28	0.53 (0.35-0.71)	52.2	71.4
Trout et al[134], 2018	MRE [kPa]	United States	NAFLD stage 0-1 vs ≥ stage 2 fibrosis in patients with steatosis	Total (n = 86), Ludwig ≥ stage 2 (n = 51), steatosis (n = 44)	Biopsy	0.94		13	100
Middleton et al[121], 2018	MRI-PDFF [%]	United States	Grade 1 steatosis vs grade 2-3	Baseline MRI (n = 110), no baseline MRI (n = 59)	Biopsy	17.5	0.87 (0.80-0.94)	74	90	97	41
Middleton et al[121], 2018	MRI-PDFF [%]	United States	Grade 1-2 steatosis vs grade 3	Baseline MRI (n = 110), no baseline MRI (n = 59)	Biopsy	23.3	0.79 (0.70-0.87)	60	90	88	65
Middleton et al[121], 2018	MRI-PDFF [%]	United States	Decrease in steatosis grade	Baseline MRI (n = 110), no baseline MRI (n = 59)	Biopsy	-11	0.76 (0.66-0.87)	31	90	78	60
Middleton et al[121], 2018	MRI-PDFF [%]	United States	Increase in steatosis grade	Baseline MRI (n = 110), no baseline MRI (n = 59)	Biopsy	5.5	0.83 (0.73-0.92)	40	90	33	92
Zhao et al[123], 2019	MRI-PDFF [%]	China	Detecting ≥ S1	Total (n = 86), Obese/overweight (n = 65), healthy nonobese controls (n = 21)	MRS	5.1	0.991 (0.977-1.00)	95	100
Di Martino et al[122], 2016	MRI-PDFF [%]	United States	Presence of steatosis	NASH (n = 27), healthy controls (n = 27)	Biopsy	3.5		89	88
Di Martino et al[122], 2016	MRS [%]	United States	Presence of steatosis	NASH (n = 27), healthy controls (n = 27)	Biopsy	6		92.6	95.7

AUROC: Area under the receiving operating characteristic; CAP: Controlled attenuation parameter; CI: Confidence interval; Dx: Diagnosis; LSM: Liver stiffness measurement; MRE: Magnetic resonance elastography; MRI: Magnetic resonance imaging; MRS: Magnetic spectroscopy; NAFL: Nonalcoholic fatty liver; NAFLD: Nonalcoholic fatty liver disease; NPV: Negative predictive value; PDFF: Proton density fat fraction; PPV: Positive predictive value; Sens: Sensitivity; Spec: Specificity; US: Ultrasound.