Influence of heterogeneities on ultrasound attenuation for liver steatosis evaluation (CAP™): Relevance of a liver guidance tool

Controlled Attenuation Parameter (CAP) is a measure of the liver ultrasound attenuation developed to assess steatosis on the Fibroscan® - vibration-controlled transient elastography based device for the clinical evaluation of liver stiffness. CAP performance was assessed in clinical studies always showing satisfactory results. However, CAP is based on the hypothesis that liver parenchyma is homogeneous whereas it is not everywhere (blood vessel, nodules, etc.). The objective of this work is to determine the influence of heterogeneities on CAP and to show the clinical relevance of a liver guidance tool, based on the statistical properties of ultrasound signals, developed to target the homogeneous parenchyma.