Many risk factors are shared between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD). In addition, NAFLD can predict higher CVD risk and related consequences independently. 2D segmentation has been used to measure liver fat on cardiac computed tomography (CT). However, the 2D approach is ineffective in diagnosing low-fat content and lacks repeatability.
Researchers wanted to determine if a new three-dimensional, 3D liver volume segmentation approach could reliably identify fatty liver on non-contrast cardiac computed tomography (CT) and further compare the results to previously validated 2D segmentation CT criteria for measuring liver fat.
The EVAPORATE trial sought to validate the occurrence and development of NAFLD in a high-risk cohort using cardiac CT. In this study, the participants from the EVAPORATE experiment were maintained on stable statin medication with low-density lipoprotein cholesterol levels (40 to 115 mg/dl) and persistently elevated triglyceride levels over an 18-month period.
Both 3D and 2D segmentation in over a hundred patients getting serial non-contrast cardiac CT exams were included in a recent study undertaken by a group of researchers from the Lundquist Institute at Harbor-UCLA Medical Center in Torrance, California, United States. The presence of less than 40 Hounsfield units in the liver attenuation was used to identify fatty liver. Philips Healthcare software was used to conduct 2D and 3D liver segmentation on non-contrast cardiac CT images.
The 3D approach for measuring liver fat was shown to be stable and repeatable in the study. The researchers also discovered that when 2D and 3D liver measurements both identified fatty liver, the kappa was 88 percent, indicating high agreement.
Dr. Suvasini Lakshmanan, an advanced cardiac imaging fellow and presenter at the annual meeting of the Society of Cardiovascular Computed Tomography (SCCT), said, "Nonetheless serial assessments of Non-alcoholic fatty liver disease (NAFLD) on cardiac CT will allow for future research to evaluate the effect of anti-inflammatory or anti-atherosclerotic therapies on cardiovascular disease and fatty liver."