Automated liver segmentation and steatosis grading using deep learning on B-mode ultrasound images

Early detection of nonalcoholic fatty liver disease (NAFLD) is crucial to avoid further complications. Ultrasound is often used for screening and monitoring of hepatic steatosis, however it is limited by the subjective interpretation of images. Computer assisted diagnosis could aid radiologists to achieve objective grading, and artificial intelligence approaches have been tested across various medical applications. In this study, we evaluated the performance of a two-stage hepatic steatosis detection deep learning framework, with a first step of liver segmentation and a subsequent step of hepatic steatosis classification. We evaluated the models on internal and external datasets, aiming to understand the generalizability of the framework. In the external dataset, our segmentation model achieved a Dice score of 0.92 (95% CI: 0.78, 1.00), and our classification model achieved an area under the receiver operating characteristic curve of 0.84 (95% CI: 0.79, 0.89). Our findings highlight the potential benefits of applying artificial intelligence models in NAFLD assessment.