Radiology Faculty and Former Research Fellow Featured in RSNA News on Imaging Fatty Liver Disease in Children 

Radiology’s Dr. Andrew Trout and former research fellow Vinicius Alves, MD, were featured on RSNA News. The article “US Performs Comparably with MR Imaging for Quantifying Fatty Liver Disease in Children” by Evonne Acevedo showcases the research performed at Cincinnati Children’s explains how “Imaging can be used to rule out other causes of liver disease.” 

The article was aimed at radiologists, but here we provide a concise explanation aimed at patients and families to share the importance of the research. 

Imaging Fatty Liver Disease in Children 

Metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD)—is increasingly prevalent among young patients. In the prospective study by the team at Cincinnati Children’s, researchers explored using both ultrasound (US) and MR imaging to diagnosis MASLD, providing valuable insights for clinicians and families. 

Why Is This Important? 

1. Screening Recommendations: 

• Most children with MASLD have no symptoms but have risk factors like obesity. 
• Based on guidelines, screening for MASLD is advised for all children aged 9 to 11 years with obesity (body mass index ?95th percentile) and for overweight children (body mass index ?85th percentile) with other risk factors like diabetes or family history. 

2. Wider Availability: Imaging, because it is noninvasive has the potential to be useful in screening and diagnosis of children with MASLD. 

• Ultrasound is more accessible than MR imaging due to its lower equipment cost and its portability. Ultrasound is also more patient-friendly. The ability to use either technique with good diagnostic performance expands options for patients and their families. 

3. Correlations Between US and MRI Measures of Liver Disease: 

• The study found a positive correlation between US shear-wave speed and stiffness measured on MR elastography. Liver stiffness is a marker of fibrosis and inflammation that can occur in MASLD. 
• When compared to MRI, US demonstrated an area under the receiver operating curve of 0.95 for predicting abnormal liver shear stiffness, with 91% sensitivity and 95% specificity. 
• For predicting abnormal liver fat, US attenuation showed 73% sensitivity and 73% specificity compared to proton density fat fraction MR imaging. 

Conclusion 

Both US and MR imaging are reasonable alternative methods for noninvasively quantifying liver disease in children with a body mass index less than 35 kg/m². Using either technique, clinicians may be able to enhance early detection and management of MASLD, ultimately benefiting our patients. 

This study underscores the importance of accessible and accurate imaging tools in safeguarding the health of our young patients. By utilizing both US and MR imaging effectively, we can make informed decisions and improve outcomes for children at risk of fatty liver disease¹.