Validation of the FibroScan‐aspartate aminotransferase score by vibration‐controlled transient and B‐mode ultrasound elastography

Abstract

Aim:The FibroScan-aspartate aminotransferase (FAST) score comprises an easy and feasible method for identifying advanced non-alcoholic steatohepatitis.Recently, shear-wave elastography and attenuation coefficient measurement on Bmode ultrasound (US) have become widely utilized. We investigated the diagnostic accuracy of the FAST score as calculated using US-elastography compared with that using vibration-controlled transient elastography (VCTE).Methods: Patients with chronic liver disease who underwent VCTE, point-shearwave elastography with attenuation coefficient measurement, and liver biopsy on the same day between January 2015 and September 2020 were retrospectively reviewed.Results: Of 189 patients, 94 underwent VCTE using both M and XL probes. The Cstatistics were similar for VCTE (0.846) and US-elastography (0.814; p = 0.251), and for M (0.857) and XL probes (0.833; p = 0.412). Scatter and Bland-Altman plots showed good reproducibility for the FAST score. For VCTE, a cut-off of ≤0.35 had a sensitivity of 92.3%, negative predictive value of 85.5%, and negative likelihood ratio of 0.14, and a cut-off of ≥0.67 had a specificity of 90.6%, positive predictive value of 88.1%, and positive likelihood ratio of 6.03, for ruling out and in advanced non-alcoholic steatohepatitis, respectively. For US-elastography, a cut-off of ≤0.35 had a sensitivity of 90.4%, negative predictive value of 83.3%, and negative likelihood ratio of 0.16, and a cutoff of ≥0.67 had a specificity of 91.8%, positive predictive value of 85.1%, and positive likelihood ratio of 4.67, for ruling out and in advanced non-alcoholic steatohepatitis, respectively. Conclusions:The FAST score is highly reproducible, even when different echo equipment or probes are used.

Diagnostic accuracy of FibroScan-AST (FAST) score for the non-invasive identification of patients with fibrotic non-alcoholic steatohepatitis: a systematic review and meta-analysis

“…The electronic search initially identified 93 records after removing 80 duplicates, of which 27 full-text articles were assessed for eligibility. Of these 27 articles, after excluding 15 publications (online supplemental material 3), 12 studies met the criteria for inclusion in the meta-analysis 16 21–31 Figure 1. summarises the PRISMA flow diagram for search and selection processes of the meta-analysis.…”

“…Since the publication of Newsome’s study in 2020,16 a number of other observational studies (as discussed in detail below) have examined the diagnostic performance of the FAST score for the non-invasive identification of fibrotic NASH, but they provided some inconsistent results 21–31. Therefore, we performed a systematic review and meta-analysis of published studies to evaluate the FAST score’s diagnostic accuracy in identifying fibrotic NASH.…”

Magnetic resonance elastography plus Fibrosis‐4 versus FibroScan–aspartate aminotransferase in detection of candidates for pharmacological treatment of NASH‐related fibrosis

“…Furthermore, the FAST score is not affected by probe selection and has high reproducibility. [21,22] Therefore, FAST may be a suitable method for screening patients with NAFLD who are candidates for NASH treatment clinical trials.…”

“…Hepatic steatosis, lobular inflammation, and hepatocyte ballooning were combined to obtain the NAFLD activity score, ranging from 0 to 8. The median (interquartile range [IQR]) specimen length and number of portal tracts were 20 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25) mm and 14 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), respectively, in the UCSD cohort and 17 (15)(16)(17)(18)(19)(20)(21)(22) mm and 12 (10)(11)(12)(13)(14)(15)(16)(17), respectively, in the Yokohama cohort.…”

Ultrasonographic Assessment of Tissue Stiffness: Recent Progress in Transient Elastography and Shear Wave Elastography in the Liver and Various Organs

“…One of the most promising modalities is transient elastography (FibroScan ® ) [12][13][14][15][16]. In addition, shear wave elastography has recently been developed as an ultrasound-based technique for noninva-sive liver stiffness evaluation [17][18][19][20]. Both transient elastography and shear wave elastography can be used to easily and accurately assess the degree of liver fibrosis in clinical practice based on ultrasound images [21,22].…”