Comparison of Ultrasound Guided Attenuation Parameter and MRI Proton Density Fat Fraction in the assessment of hepatic steatosis in Indian adolescents: A pilot study

Objectives: To compare hepatic fat in Indian adolescents as assessed using UGAP with MRI PDFF methods

Methodology: Details on SES, habitual dietary assessment, physical activity questionnaire, anthropometric measurements and a detailed clinical examination will be conducted for every subject. Biochemical analysis will be carried out in 4 ml of fasting venous blood samples collected at recruitment. Hemoglobin estimation, fasting blood sugar, serum HDL-cholesterol, serum triglycerides, serum aspartate aminotransferase and serum alanine aminotransferase will be estimated. All subjects will undergo total body composition measurement by the Dual energy X Ray absorptiometry DEXA machine. Hepatic fat quantification will be done in each subject using MRI PDFF and UGAP methods one after another. For MRI PDFF, a 3.0 T system GE Signa Architect will be used and a 3D volumetric, greater than 16sec breath hold sequence for fat quantification will be performed. UGAP will be performed for each subject by a single radiologist in the radiology suite using LOGIQ E10 ultrasound system GE Healthcare

Need of the study: Of concern in India, is that in national child surveys, an increase in biomarkers of metabolic obesity is occurring even in those children who apparently appear anthropometrically undernourished. On-invasive screening modality which can pick up early signs of ill-health or metabolic dysregulation in children is the need of the hour. This will help in instituting lifestyle changes, prevent tracking of disease into adulthood and reduce the burden of chronic disease. Though, MRI PDFF is accurate in detecting and quantifying hepatic fat, it is limited by accessibility and is inapplicable as a screening technique. UGAP can be performed in all ages, is portable and cost effective, but requires validation in Indian children for diagnostic accuracy with MRI PDFF.