Hepatic steatosis in participants in a program of low-dose CT screening for lung cancer.
OBJECTIVE
Determine the frequency of moderate-to-severe hepatic steatosis (HS) in asymptomatic participants in a low-dose CT (LDCT) screening program for lung cancer, to identify risk factors, and develop recommendations.


METHODS
Baseline LDCT scans of the chest of 170 participants in an IRB-approved study between August 2011 and April 2016 were reviewed. Demographic variables, comorbidities, and liver function tests were documented. Hepatic and splenic attenuation values hounsfield unit (HU) were measured. Regression analyses were performed.


RESULTS
Average liver attenuation was 57.6HU (standard deviation (SD) 9.3) and average liver/spleen (L/S) ratio was 1.3 (SD 0.3). Liver attenuation was <40HU for 9 (5.3%), liver/spleen (L/S) ratio <0.8 for 6 (3.5%), and either <40HU or L/S ratio <0.8 for 9 (5.3%). Male sex (p=0.004), diabetes (p=0.0005), emphysema (p=0.03), and high BMI (p=0.0006) were significant predictors of HS. Aspartate aminotransferase (p=0.0018) and alanine aminotransferase (p=0.012) were negatively correlated with liver attenuation. Reduced serum levels of alpha-1-antitrypsin may be a common factor of emphysema and HS.


CONCLUSION
LDCT can detect HS in asymptomatic participants with frequencies similar to previous reports. If liver attenuation is below 40HU and/or L/S ratio below 0.8, further evaluation of HS to the primary care physician or liver specialist is recommended.
['Chen|Xiangmeng|X|', 'Li|Kunwei|K|', 'Yip|Rowena|R|', 'Perumalswami|Ponni|P|', 'Branch|Andrea D|AD|', 'Lewis|Sara|S|', 'Del Bello|David|D|', 'Becker|Betsy J|BJ|', 'Yankelevitz|David F|DF|', 'Henschke|Claudia I|CI|']
D000410:Alanine Transaminase D001219:Aspartate Aminotransferases D005234:Fatty Liver D005260:Female D006801:Humans D008111:Liver Function Tests D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D011857:Radiographic Image Interpretation, Computer-Assisted D012307:Risk Factors D012680:Sensitivity and Specificity D014057:Tomography, X-Ray Computed
Hepatic steatosis Screening Lung cancer Liver attenuation Computed tomography Smoking