Title: Ultrasound-Derived Fat Fraction: A Novel Approach for Assessing Wilson's Disease-
Related Hepatic Steatosis
Version: 1 Date: 08 Mar 2025
Reviewer's report:
This study is interesting and organized by aims to investigate Ultrasound-Derived Fat Fraction:
A Novel Approach for Assessing Wilson's Disease-Related Hepatic Steatosis. However, there
are serious correction needs to be followed-up:
• The study aims to determine the if UDFF is an effective indicator in patients with WD, but
it would be helpful to justify why this threshold is clinically important and how it might differ
from NAFLD.
• A word of “citation” in the beginning of the text should be replaced by a word “Introduction”
• The introduction does not mention potential confounding factors that could affect UDFF
measurements, such as hepatic fibrosis, dietary habits, metabolic factors, or genetic modifiers
that might influence hepatic steatosis in WD. A brief discussion of these factors would improve
the study’s transparency.
• While the study focuses on WD, does it have potential implications for other liver diseases
associated with metabolic abnormalities?
• While prior studies have validated UDFF against MRI-PDFF in NAFLD, Why it does not
compare UDFF in WD patients with MRI-PDFF directly to further validate its accuracy?
• The sample size (n=89) is relatively modest. Larger cohorts across multiple centers could
enhance the generalizability of findings.
• The study provides cross-sectional data; however, longitudinal follow-up should be suggested
for future direction as it could assess the effectiveness of UDFF in monitoring disease
progression and response to treatment.
• While a useful semi-quantitative method, the Hamaguchi score may introduce observer bias.
Consider discussing potential limitations and alternative validation methods for the future
directions.
Title: Ultrasound-Derived Fat Fraction: A Novel Approach for Assessing Wilson's Disease-
Related Hepatic Steatosis
Version: 1 Date: 08 Mar 2025
Reviewer's report:
This study is interesting and organized by aims to investigate Ultrasound-Derived Fat Fraction:
A Novel Approach for Assessing Wilson's Disease-Related Hepatic Steatosis. However, there
are serious correction needs to be followed-up:
• The study aims to determine the if UDFF is an effective indicator in patients with WD, but
it would be helpful to justify why this threshold is clinically important and how it might differ
from NAFLD.
• A word of “citation” in the beginning of the text should be replaced by a word “Introduction”
• The introduction does not mention potential confounding factors that could affect UDFF
measurements, such as hepatic fibrosis, dietary habits, metabolic factors, or genetic modifiers
that might influence hepatic steatosis in WD. A brief discussion of these factors would improve
the study’s transparency.
• While the study focuses on WD, does it have potential implications for other liver diseases
associated with metabolic abnormalities?
• While prior studies have validated UDFF against MRI-PDFF in NAFLD, Why it does not
compare UDFF in WD patients with MRI-PDFF directly to further validate its accuracy?
• The sample size (n=89) is relatively modest. Larger cohorts across multiple centers could
enhance the generalizability of findings.
• The study provides cross-sectional data; however, longitudinal follow-up should be suggested
for future direction as it could assess the effectiveness of UDFF in monitoring disease
progression and response to treatment.
• While a useful semi-quantitative method, the Hamaguchi score may introduce observer bias.
Consider discussing potential limitations and alternative validation methods for the future
directions.
Please review this paper.
user
Title: Ultrasound-Derived Fat Fraction: A Novel Approach for Assessing Wilson's Disease-
Related Hepatic Steatosis
Version: 1 Date: 08 Mar 2025
Reviewer's report:
This study is interesting and organized by aims to investigate Ultrasound-Derived Fat Fraction:
A Novel Approach for Assessing Wilson's Disease-Related Hepatic Steatosis. However, there
are serious correction needs to be followed-up:
• The study aims to determine the if UDFF is an effective indicator in patients with WD, but
it would be helpful to justify why this threshold is clinically important and how it might differ
from NAFLD.
• A word of “citation” in the beginning of the text should be replaced by a word “Introduction”
• The introduction does not mention potential confounding factors that could affect UDFF
measurements, such as hepatic fibrosis, dietary habits, metabolic factors, or genetic modifiers
that might influence hepatic steatosis in WD. A brief discussion of these factors would improve
the study’s transparency.
• While the study focuses on WD, does it have potential implications for other liver diseases
associated with metabolic abnormalities?
• While prior studies have validated UDFF against MRI-PDFF in NAFLD, Why it does not
compare UDFF in WD patients with MRI-PDFF directly to further validate its accuracy?
• The sample size (n=89) is relatively modest. Larger cohorts across multiple centers could
enhance the generalizability of findings.
• The study provides cross-sectional data; however, longitudinal follow-up should be suggested
for future direction as it could assess the effectiveness of UDFF in monitoring disease
progression and response to treatment.
• While a useful semi-quantitative method, the Hamaguchi score may introduce observer bias.
Consider discussing potential limitations and alternative validation methods for the future
directions.
assistant