Table 1.
Characteristics of Pediatric Studies Comparing Steatosis by Imaging with a Quantitative Reference
| Reference | First Author (year) | Country | N | Age range (y) | Population | Comparator | Definition for fatty liver | Evaluation of severity of steatosis |
|---|---|---|---|---|---|---|---|---|
| Ultrasonograpy | ||||||||
| Pacifico (2007) | Italy | 50 | 5–16 | Children with BMI >95% referred for evaluation for fatty liver upon detection of hepatomegaly and/or elevated liver chemistry | MRI | MRI HFF ≥9% | Continuous hepatic fat fraction | |
| Pozzato (2008) | Italy | 60 | 6–14 | Obese children with White parents admitted for obesity. | MRI | MRI HFF ≥9% | MRI HFF ≥9% | |
| El-Koofy (2011) | Egypt | 70 | 2–13 | Obese children referred from Endocrinology for assessment of hepatic abnormalities; clinical hepatomegaly, raised ALT and/or echogenic liver parenchyma by ultrasound | Histology | >5% of hepatocytes with steatosis | Ordinal histologic steatosis score | |
| Shannon (2011) | Italy | 208 | 3–14 | Children with biopsy proven NAFLD | Histology | >5% of hepatocytes with steatosis | Ordinal histologic steatosis score | |
| Bohte (2012) | Netherlands | 104 | 8–18 | Obese children admitted to a tertiary center lifestyle intervention program based on BMI >30kg/m2 along with obesity-related comorbidity | Spectroscopy | Greater than 1.8% absolute concentration of spectroscopic liver fat | Center defined MRS cut points for mild, moderate, severe steatosis | |
| MRI | ||||||||
| Yokoo (2009) | USA | 30 | 8–18 | Recruited from the institutional hepatology and obesity clinics | Spectroscopy | Threshold value of 6.25% for spectroscopic fat fraction | Continuous spectroscopic fat fraction | |
| Yokoo (2011) | USA | 34 | 10–18 | Referred by hepatologists and surgeons | Spectroscopy | Various MRS thresholds: 0.04, 0.06, 0.08, 0.10 | Continuous spectroscopic fat fraction | |
| Pacifico (2011) | Italy | 25 | 7–16 | Obese Caucasian children with suspected NAFLD based on elevated serum ALT and diffusely hyperechogenic liver on US, and hyperinsulinism | Histology | >5% of hepatocytes with steatosis | Ordinal histologic steatosis score | |
| Springer (2011) | Germany | 29 | 11–16 | Severely obese adolescents referred for treatment | Spectroscopy | Intrahepatic lipid content >5% | Continuous spectroscopic fat fraction | |
Abbreviations: ALT (alanine aminotransferase), HFF (hepatic fat fraction), NAFLD (nonalcoholic fatty liver disease), NASH (nonalcoholic steatohepatitis), MRI (magnetic resonance imaging), US (ultrasound)