Controlled attenuation parameter measured using transient elastography for the noninvasive assessment of macrovesicular steatosis in potential living liver donors
Purpose@#This study aimed to determine the diagnostic performance of the controlled attenuation parameter (CAP) measured using transientelastography (TE) for assessing macrovesicular steatosis (MaS) in potential living liverdonors using same-day biopsy as a reference standard. @*Methods@#This retrospective study included 204 living liverdonor candidates who underwent TE and liverbiopsy on the same day between July 2013 and June 2014. The histologic degree of MaS was determined. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of CAP for diagnosing MaS of >10%, and the optimal cutoff value was identified using the maximal Youden index. @*Results@#Based on liverbiopsy, 185 subjects had MaS of ≤10% and 19 had MaS of >10%. The CAP value was significantly correlated with the percentage of MaS on liverbiopsy (r=0.635, P10% than in those with MaS of ≤10% (300 dB/m vs. 209 dB/m, P10% by CAP was 0.938 (95% confidence interval, 0.896 to 0.967), and a CAP of >259 dB/m yielded a sensitivity of 84.2% and a specificity of 92.4%. @*Conclusion@#The CAP measured using TE was significantly correlated with MaS and accurately detected substantial MaS in potential living liverdonors. The CAP is a promising tool for the noninvasive diagnosis of MaS and may be used to screen unsuitable living liverdonor candidates.