# Comparison of accuracy of CT parameters across chest, low-dose lung, and abdominal CT in diagnosing steatotic liver disease

## TL;DR

This study compares how well CT scans of the chest, lungs, and abdomen can detect fatty liver disease, finding that chest and low-dose lung scans are as effective as abdominal scans.

## Contribution

The study demonstrates that chest and low-dose lung CT scans can accurately diagnose steatotic liver disease, offering alternative imaging options.

## Key findings

- Abdominal CT liver attenuation (CTL) was the most accurate marker for SLD with high sensitivity and specificity.
- Chest and low-dose lung CT parameters showed diagnostic accuracy comparable to abdominal CT for SLD.
- CTL−S provided stable diagnostic performance across all scanning protocols.

## Abstract

This study aims to determine the accuracy of computed tomography (CT) parameters obtained from three various scanning protocols (chest CT, low-dose lung CT, and abdominal CT) in diagnosing steatotic liver disease (SLD).

This retrospective study included 234 individuals who underwent chest CT, low-dose lung CT, or abdominal CT. SLD presence or absence was confirmed through ultrasound in all participants. Two radiologists independently measured the CT attenuation values of the liver (CTL) and spleen (CTS). The differences (CTL−S) and ratios (CTL/S) between liver and spleens values were calculated. Independent sample t-tests or Mann–Whitney U tests were used to compare CTS, CTL, CTL−S, and CTL/S between SLD and control groups. One-way analysis of covariance or Kruskal–Wallis H tests were conducted to compare the parameters across scanning protocols. Receiver operating characteristic (ROC) analysis was performed.

The parameters (CTL, CTL−S, and CTL/S) were significantly lower in the SLD group than in the control group across all scanning protocols (P < 0.001). In the control group, significant differences in CTS and CTL were observed among the three scanning protocols (P < 0.05), while non-statistically significant differences were found for CTL−S or CTL/S across protocols in either group (P > 0.05). The ROC analysis revealed abdominal CTL as the most accurate diagnostic marker for SLD (area under the curve [AUC]: 0.894, sensitivity: 90.91%, specificity: 83.33%). CTL−S maintained stable diagnostic performance across protocols (AUC range: 0.813–0.816). The low-dose protocol achieved the best performance for CTL/S (AUC: 0.810), demonstrating high specificity (94.34%) despite moderate sensitivity (64.81%).

Both chest CT and low-dose CT-derived parameters demonstrated diagnostic accuracy comparable to that of abdominal CT in assessing SLD, suggesting their potential as viable alternatives in specific clinical scenarios.