Abstract：
OBJECTIVE: SmartExam is a novel computational method compatible with FibroScan that uses a software called SmartDepth and continuous controlled attenuation parameter measurements to evaluate liver fibrosis and steatosis. This retrospective study compared the diagnostic accuracy of conventional and SmartExam-equipped FibroScan for liver stiffness measurement (LSM).
METHODS: The liver stiffness and the associated controlled attenuation parameters of 167 patients were measured using conventional and SmartExam-Equipped FibroScan as well as reference methods like magnetic resonance elastography (MRE) and magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) measurements to assess its diagnostic performance. M or XL probes were selected based on the probe-to-liver capsule distance for all FibroScan examinations.
RESULTS: The liver stiffness and controlled attenuation parameter (CAP) correlation coefficients calculated from conventional and SmartExam-equipped FibroScan were 0.97 and 0.82, respectively. Using MRE/MRI-PDFF as a reference and the DeLong test for analysis, LSM and the area under the receiver operating characteristic curve for CAP measured by conventional and SmartExam-equipped FibroScan showed no significant difference. However, the SmartExam-equipped FibroScan measurement (33.6 s) took 1.4 times longer than conventional FibroScan (23.2 s).
CONCLUSIONS: SmartExam has a high diagnostic performance comparable with that of conventional FibroScan. Because the results of the conventional and SmartExam-equipped FibroScan were strongly correlated, it can be considered useful for assessing the fibrosis stage and steatosis grade of the liver in clinical practice, with less variability but little longer measurement time compared with the conventional FibroScan.
METHODS: The liver stiffness and the associated controlled attenuation parameters of 167 patients were measured using conventional and SmartExam-Equipped FibroScan as well as reference methods like magnetic resonance elastography (MRE) and magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) measurements to assess its diagnostic performance. M or XL probes were selected based on the probe-to-liver capsule distance for all FibroScan examinations.
RESULTS: The liver stiffness and controlled attenuation parameter (CAP) correlation coefficients calculated from conventional and SmartExam-equipped FibroScan were 0.97 and 0.82, respectively. Using MRE/MRI-PDFF as a reference and the DeLong test for analysis, LSM and the area under the receiver operating characteristic curve for CAP measured by conventional and SmartExam-equipped FibroScan showed no significant difference. However, the SmartExam-equipped FibroScan measurement (33.6 s) took 1.4 times longer than conventional FibroScan (23.2 s).
CONCLUSIONS: SmartExam has a high diagnostic performance comparable with that of conventional FibroScan. Because the results of the conventional and SmartExam-equipped FibroScan were strongly correlated, it can be considered useful for assessing the fibrosis stage and steatosis grade of the liver in clinical practice, with less variability but little longer measurement time compared with the conventional FibroScan.
摘要：
目的：SmartExam是一种与FibroScan兼容的新颖计算方法，该方法使用称为SmartDepth的软件和连续控制的衰减参数测量来评估肝纤维化和脂肪变性。这项回顾性研究比较了常规和配备SmartExam的FibroScan用于肝脏硬度测量（LSM）的诊断准确性。
方法：使用常规和配备SmartExam的FibroScan以及磁共振弹性成像（MRE）和磁共振成像等参考方法测量167例患者的肝脏硬度和相关的受控衰减参数基于质子密度脂肪分数（MRI-PDFF）的测量来评估其诊断性能。对于所有FibroScan检查,基于探针到肝脏囊的距离选择M或XL探针。
结果：从常规和配备SmartExam的FibroScan计算的肝脏硬度和受控衰减参数（CAP）相关系数分别为0.97和0.82。使用MRE/MRI-PDFF作为参考，并使用DeLong测试进行分析，通过常规和配备SmartExam的FibroScan测量的CAP的LSM和接收器工作特性曲线下面积没有显着差异。然而,配备SmartExam的FibroScan测量时间（33.6s）是传统FibroScan测量时间（23.2s）的1.4倍。
结论：SmartExam具有与常规FibroScan相当的高诊断性能。因为常规和配备SmartExam的FibroScan的结果密切相关，它可以被认为在临床实践中用于评估肝脏的纤维化阶段和脂肪变性等级，与传统的FibroScan相比，可变性较小，但测量时间较长。
方法：使用常规和配备SmartExam的FibroScan以及磁共振弹性成像（MRE）和磁共振成像等参考方法测量167例患者的肝脏硬度和相关的受控衰减参数基于质子密度脂肪分数（MRI-PDFF）的测量来评估其诊断性能。对于所有FibroScan检查,基于探针到肝脏囊的距离选择M或XL探针。
结果：从常规和配备SmartExam的FibroScan计算的肝脏硬度和受控衰减参数（CAP）相关系数分别为0.97和0.82。使用MRE/MRI-PDFF作为参考，并使用DeLong测试进行分析，通过常规和配备SmartExam的FibroScan测量的CAP的LSM和接收器工作特性曲线下面积没有显着差异。然而,配备SmartExam的FibroScan测量时间（33.6s）是传统FibroScan测量时间（23.2s）的1.4倍。
结论：SmartExam具有与常规FibroScan相当的高诊断性能。因为常规和配备SmartExam的FibroScan的结果密切相关，它可以被认为在临床实践中用于评估肝脏的纤维化阶段和脂肪变性等级，与传统的FibroScan相比，可变性较小，但测量时间较长。
