Measurement of LiSA was performed with Hepatus, a newly developed ultrasound machine, with a 3.5-MHz phased array probe (LFP5-1U, Mindray, Re 6S, China). FibroScan with an M probe (Echosens, FibroScan 502, France) was used to measure CAP. The attenuation of ultrasound propagation in the liver tissue is increased by fat accumulation. Therefore, the detection of ultrasonic attenuation coefficient is a quantitative method for evaluating the degree of liver steatosis (10). Both LiSA and CAP measure the total ultrasonic attenuation (go-and-return path) in the liver at 3.5 MHz, which is expressed in decibels per meter (dB/m). CAP measures the ultrasonic attenuation in the liver tissue along the vertical axis of the probe (one dimension), while LiSA detects the mean ultrasonic attenuations in liver tissue at the region of interest (two dimension) (Figure 1A). The actual visual measurement screen of LiSA is shown in Figure 1B.

Liver steatosis analysis (LiSA). (A) The difference between controlled attenuation parameter (CAP) and LiSA in the detection of ultrasound attenuation in the liver. (B) Actual measurement screen of LiSA.

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