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Ultrasound-derived fat fraction for diagnosing hepatic steatosis: a systematic review and meta-analysis.

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Title: Ultrasound-derived fat fraction for diagnosing hepatic steatosis: a systematic review and meta-analysis.
Authors: Verdan, Sarah1 (AUTHOR) contatosarahverdan@gmail.com, Torri, Giovanni B.2 (AUTHOR), Marcos, Vinícius Neves1 (AUTHOR), Moreira, Maria Helena Silva1 (AUTHOR), Defante, Maria Luiza R.3 (AUTHOR), Fagundes, Marília da Cruz4 (AUTHOR), de Barros, Emanuela Mendes Junqueira5 (AUTHOR), Dias, Adriano B.6 (AUTHOR), Shen, Luyao7 (AUTHOR), Altmayer, Stephan7 (AUTHOR)
Source: European Radiology. Nov2025, Vol. 35 Issue 11, p7421-7430. 10p.
Subjects: Fatty liver, Diagnosis, Noninvasive diagnostic tests, Computer-assisted image analysis (Medicine), Fat content of food
Abstract: Objective: To perform a systematic review and meta-analysis to evaluate the diagnostic performance of Ultrasound-Derived Fat Fraction (UDFF) in detecting hepatic steatosis using Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF) as the reference standard. Materials and methods: Relevant databases were searched through November 2024. Studies that evaluated the UDFF to detect hepatic steatosis using MRI-PDFF as the reference standard met the inclusion criteria. Our primary outcome was the sensitivity and specificity of UDFF compared to MRI-PDFF in distinguishing steatosis from non-steatosis. Analyses were performed using a bivariate random-effects approach, and heterogeneity was considered substantial if I2 > 50%. A sensitivity analysis was performed to detect potential studies that contribute to heterogeneity. Results: Nine studies comprising 1150 patients (mean age range, 14–62 years; 51.2% women) were included. Eight studies were performed using the same vendor platform. The pooled sensitivity of UDFF for detecting hepatic steatosis was 90.4% (95% CI: 84.0%, 94.4%), and the pooled specificity was 83.8% (95% CI: 75.1%, 89.8%). The AUC for the summary receiver-operating characteristic curve was 0.93 (95% CI: 0.83, 0.95). Heterogeneity among the studies was low (I² = 22.2%). Conclusion: UDFF demonstrates high sensitivity and specificity for detecting hepatic steatosis, supporting its value as a noninvasive tool for screening. Key Points: QuestionSmall individual studies suggest that US-Derived Fat Fraction (UDFF) may effectively detect hepatic steatosis compared to MRI, but no meta-analysis has been performed. FindingsIn nine studies including 1150 patients, UDFF demonstrated high pooled sensitivity (90.4%) and specificity (83.8%) relative to MRI with low between-study heterogeneity. Clinical relevanceUDFF demonstrates high diagnostic accuracy compared with MRI, supporting its use as a noninvasive tool with potentially lower cost and wider availability for large-scale screening of hepatic steatosis. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
  Group: Ti
  Data: Ultrasound-derived fat fraction for diagnosing hepatic steatosis: a systematic review and meta-analysis.
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  Data: <searchLink fieldCode="AR" term="%22Verdan%2C+Sarah%22">Verdan, Sarah</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> contatosarahverdan@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Torri%2C+Giovanni+B%2E%22">Torri, Giovanni B.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marcos%2C+Vinícius+Neves%22">Marcos, Vinícius Neves</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Moreira%2C+Maria+Helena+Silva%22">Moreira, Maria Helena Silva</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Defante%2C+Maria+Luiza+R%2E%22">Defante, Maria Luiza R.</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fagundes%2C+Marília+da+Cruz%22">Fagundes, Marília da Cruz</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22de+Barros%2C+Emanuela+Mendes+Junqueira%22">de Barros, Emanuela Mendes Junqueira</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dias%2C+Adriano+B%2E%22">Dias, Adriano B.</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shen%2C+Luyao%22">Shen, Luyao</searchLink><relatesTo>7</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Altmayer%2C+Stephan%22">Altmayer, Stephan</searchLink><relatesTo>7</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Nov2025, Vol. 35 Issue 11, p7421-7430. 10p.
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22Fatty+liver%22">Fatty liver</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Noninvasive+diagnostic+tests%22">Noninvasive diagnostic tests</searchLink><br /><searchLink fieldCode="DE" term="%22Computer-assisted+image+analysis+%28Medicine%29%22">Computer-assisted image analysis (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Fat+content+of+food%22">Fat content of food</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: To perform a systematic review and meta-analysis to evaluate the diagnostic performance of Ultrasound-Derived Fat Fraction (UDFF) in detecting hepatic steatosis using Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF) as the reference standard. Materials and methods: Relevant databases were searched through November 2024. Studies that evaluated the UDFF to detect hepatic steatosis using MRI-PDFF as the reference standard met the inclusion criteria. Our primary outcome was the sensitivity and specificity of UDFF compared to MRI-PDFF in distinguishing steatosis from non-steatosis. Analyses were performed using a bivariate random-effects approach, and heterogeneity was considered substantial if I2 > 50%. A sensitivity analysis was performed to detect potential studies that contribute to heterogeneity. Results: Nine studies comprising 1150 patients (mean age range, 14–62 years; 51.2% women) were included. Eight studies were performed using the same vendor platform. The pooled sensitivity of UDFF for detecting hepatic steatosis was 90.4% (95% CI: 84.0%, 94.4%), and the pooled specificity was 83.8% (95% CI: 75.1%, 89.8%). The AUC for the summary receiver-operating characteristic curve was 0.93 (95% CI: 0.83, 0.95). Heterogeneity among the studies was low (I² = 22.2%). Conclusion: UDFF demonstrates high sensitivity and specificity for detecting hepatic steatosis, supporting its value as a noninvasive tool for screening. Key Points: QuestionSmall individual studies suggest that US-Derived Fat Fraction (UDFF) may effectively detect hepatic steatosis compared to MRI, but no meta-analysis has been performed. FindingsIn nine studies including 1150 patients, UDFF demonstrated high pooled sensitivity (90.4%) and specificity (83.8%) relative to MRI with low between-study heterogeneity. Clinical relevanceUDFF demonstrates high diagnostic accuracy compared with MRI, supporting its use as a noninvasive tool with potentially lower cost and wider availability for large-scale screening of hepatic steatosis. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Group: Ab
  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-025-11652-8
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      – SubjectFull: Fatty liver
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      – SubjectFull: Fat content of food
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