A novel 2-step approach combining the NAFLD fibrosis score and liver stiffness measurement for predicting advanced fibrosis

Chan, Wah‐Kheong; Mustapha, Nik Raihan Nik; Mahadeva, Sanjiv

doi:10.1007/s12072-014-9596-7

Cited by 50 publications

(55 citation statements)

References 21 publications

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“…Recently, Chan et al . of Malaysia proposed a two‐step approach combining the NFS with LSM to predict advanced fibrosis . They reported that a two‐step approach using LSM only for patients with indeterminate and high values of the NFS to predict advanced fibrosis allowed the number of liver biopsies performed to identify patients with advanced fibrosis to be reduced.…”

Section: Discussionmentioning

confidence: 99%

Distribution of liver stiffness in non‐alcoholic fatty liver disease with higher fibrosis‐4 index than low cut‐off index

Tomeno

Imajo

Kuwada³

et al. 2019

J of Gastro and Hepatol

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Background and Aim In the condition of high prevalence of non‐alcoholic fatty liver disease (NAFLD), a new diagnostic algorithm to efficiently identify NAFLD patients with significant fibrosis is urgently required. We evaluated the predictive ability of the fibrosis‐4 index (FIB‐4 index) for significant liver fibrosis (F ≥ 2) in a cohort of Japanese patients with NAFLD. Methods We prospectively calculated the FIB‐4 index in patients who were incidentally diagnosed as fatty liver in medical checkups and then conducted liver stiffness measurement by vibration‐controlled transient elastography (VCTE) only in patients in whom the FIB‐4 index was more than the low cut‐off index (> 1.45). Results Of the 5929 people who underwent medical checkups, a total of 1374 people were identified as having fatty liver. Among these, we performed VCTE in 106 patients in whom the FIB‐4 index was higher than 1.45. The distribution of the fibrosis stage as estimated by VCTE in the patients was as follows: F0, 52.8%; F1, 10.3%; F2, 21.6%; F3, 11.3%; and F4, 3.7%. The positive predictive value of the FIB‐4 index for detecting NAFLD with significant fibrosis was 36.6%. The minimum value of the FIB‐4 index was constant for each estimated fibrosis stage. Conclusions This is the first prospective study to evaluate the usefulness of the FIB‐4 index as the first step to screen NAFLD patients with significant fibrosis. In Japan, addition of one further step that combined with the FIB‐4 index is necessary to meaningfully reduce the number of patients needing liver stiffness measurement or liver biopsy.

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Section: Discussionmentioning

confidence: 99%

Distribution of liver stiffness in non‐alcoholic fatty liver disease with higher fibrosis‐4 index than low cut‐off index

Tomeno

Imajo

Kuwada³

et al. 2019

J of Gastro and Hepatol

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“…This approach has been tested in various patient populations with viral hepatitis . However, such data for NAFLD are scarce, and FibroMeter is rarely used in existing studies . The current study represents one of the largest histological series to test the combined performance of transient elastography and FibroMeter in NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Application of the combined FibroMeter vibration‐controlled transient elastography algorithm in Chinese patients with non‐alcoholic fatty liver disease

Loong

Wei

Leung

et al. 2017

J of Gastro and Hepatol

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“…In the same cohort, use of VCTE with cutoffs <8kpa and >17kpa, the negative predictive value and positive predictive values were higher, 98.2 and 89% respectively. 60 A strategy based on concordant results (e.g. low NAFLD fibrosis and low stiffness) was proposed.…”

Section: A Comparison Of Radiology Markers: In a Study Examining 2d mentioning

confidence: 99%

Incorporation of Noninvasive Measures of Liver Fibrosis Into Clinical Practice: Diagnosis and Prognosis

Asrani¹

2015

Clinical Gastroenterology and Hepatology

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A novel 2-step approach combining the NAFLD fibrosis score and liver stiffness measurement for predicting advanced fibrosis

Abstract: The novel 2-step approach further reduced the number of patients requiring a liver biopsy whilst maintaining the accuracy to predict advanced fibrosis. The combination of NFS and LSM for all patients provided no apparent advantage over using either of the tests alone.

Cited by 50 publications

References 21 publications

Distribution of liver stiffness in non‐alcoholic fatty liver disease with higher fibrosis‐4 index than low cut‐off index

Distribution of liver stiffness in non‐alcoholic fatty liver disease with higher fibrosis‐4 index than low cut‐off index

Application of the combined FibroMeter vibration‐controlled transient elastography algorithm in Chinese patients with non‐alcoholic fatty liver disease

Incorporation of Noninvasive Measures of Liver Fibrosis Into Clinical Practice: Diagnosis and Prognosis

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