Ultrasound Attenuation, Liver Texture Index, and HepatoRenal Index: Assessing Reproducibility and Inter-operator Consistency in Clinical Practice

Abstract

Aim: This study aimed to evaluate the reproducibility of Ultrasound Attenuation (USAT), the Liver Texture Index (LTI) and the HepatoRenal Index (HRI).

Material and methods: Between May 2023 to December 2023, 279 patients who underwent USAT, LTI and HRI tests at the Ultrasound Department of The Second Affiliated Hospital, School of Medicine, The Chinese University of Hong Kong, Shenzhen were included. All patients were examined by a physician with over 4 years of ultrasound experience. The intra-class correlation coefficient (ICC) was utilized to assess the reproducibility of the three quantitative parameters in all patients. Additionally, 63 cases were examined by another physician with six months of experience to evaluate inter-operator reproducibility.

Results: The intra-operator reproducibility of USAT, LTI, and HRI were 0.879 (95% CI:0.858-0.898), 0.919 (95% CI:0.904-0.933), and 0.836 (95% CI:0.809-0.862), respectively. The inter-operator reproducibility among different operators were 0.790 (95% CI:0.604-0.894), 0.782 (95% CI:0.591-0.890), and 0.631 (95% CI:0.356-0.806). After 30 operations, the inter-operator reproducibility improved to 0.858 (95% CI:0.731-0.927), 0.909 (95% CI:0.823-0.954), and 0.796 (95% CI:0.587-0.899).

Conclusions: USAT, LTI, and HRI have shown good intra-operator reproducibility, and inter-operator reproducibility between the two operators reached a comparable level after 30 training cases.