Diagnostic Performance of 2D ROI Sampling and 3D Volumetric Methods in Liver Attenuation Assessment using Non Contrast CT: A Retrospective Observational Study

Introduction: Fatty liver disease, or hepatic steatosis, is a highly prevalent condition that can be non-invasively diagnosed using Computed Tomography (CT) attenuation values. However, the optimal method for attenuation measurement remains uncertain. Aim: To compare the performance of three CT-based techniques-Two dimensional (2D) sampling, Three dimensional (3D) sampling, and whole-liver segmentation-using non-contrast scans. Materials and Methods: The present retrospective analysis of 230 patients (121 normal, 109 with fatty liver) was conducted in the Radiology Department at Madha Medical College & Research Institute, Chennai, Tamil Nadu, India. The study included patients who underwent both Ultrasonography (USG) and CT between January 2023 and December 2023. Fatty liver diagnosis was confirmed using both ultrasound and noncontrast CT attenuation values {