Table 1 Considerations when sharing non-invasive test results with patients for hepatic steatosis and fibrosis in MASLD
From: The importance of patient engagement in the multimodal treatment of MASLD
Hepatic steatosis | |||
|---|---|---|---|
Test | Test type | Consideration | Ref. |
Fatty liver index | Blood-based | >Differentiation of higher steatosis grades is inaccurate >Indeterminate zone (30;60) difficult to interpret >Not liver-specific | |
Ultrasound | Imaging-based | >High inter- and intra- observer variability, limited reproducibility >Low accuracy for grading steatosis | |
VCTE - CAP | Imaging-based | >Differentiation of higher steatosis grades is inaccurate >Moderate accuracy in patients with obesity | |
Hepatic fibrosis | |||
Test | Consideration | Ref. | |
Fibrosis-4 score | Blood-based | >Inaccurate in people younger than 35 years >Unspecific in patients older than 65 years >Can be false positive when another cause of thrombocytopenia is present, such as HIV-infection >Better at excluding than including advanced fibrosis >Indeterminate zone (1.3;2.67) difficult to interpret >Results can be impacted by liver congestion >Not liver-specific | |
NAFLD fibrosis score | Blood-based | >Inaccurate in people younger than 35 years >Unspecific in patients older than 65 years >Better at excluding than including advanced fibrosis >Indeterminate zone (-1.455;0.676) difficult to interpret >Not liver-specific | |
Enhanced liver fibrosis score | Blood-based | >High sensitivity but limited specificity for excluding significant/advanced fibrosis at low cutoffs >High negative predictive value >Influenced by age, inflammation, and matrix turnover | |
VCTE - LSM | Imaging-based | >Results can be impacted by liver congestion, ascites, active hepatitis, food intake, biliary obstruction, and amyloidosis >Results are less reliable in people with severe obesity >Better at ruling out than ruling in cirrhosis >Results obtained with the XL-probe are often lower than those obtained with the M-probe >CAP values higher than 300 dB can overestimate LSM in case of low fibrosis stage >Differentiating lower fibrosis stages is inaccurate | |
