NOVEL INSIGHTS INTO THE ACCURACY OF FIB-4 AND FIBROSCAN SCORES COMPARED TO LIVER BIOPSY IN THE ASSESSMENT OF LIVER FIBROSIS IN PATIENTS WITH MASLD

Document Type

Conference Proceeding

Publication Date

10-9-2024

Publication Title

Hepatology

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent, with fibrosis stage being a critical predicting prognosis. Liver biopsy is the gold standard for staging but is invasive and costly. Non-invasive tests like FibroScan and FIB4 aid in pre-selecting patients for biopsy. This study compares FibroScan and FIB4 accuracy in predicting fibrosis staging in patients with MASLD. Methods: A cross-sectional study on 116 MASLD patients undergoing both FibroScan and liver biopsy within one year was conducted. Demographic, biochemical data, and FIB4 levels were collected. Patients were categorized by fibrosis levels: minimal/no (F0-F1), moderate (F2- F3), and severe (F4), using FibroScan kPa scores, FIB4 levels, and biopsy results. Results: Of 116 patients (55 males, 61 females; 82 < 65 years, 34 older; 89 white, 25 non-white; 26 BMI < 30, 89 BMI > 30), 37.07% were F0-1 by FIB4, with 64.71% agreement by FibroScan. For F2-3, 58.62% were identified by FIB4, with 60% agreement by FibroScan. In F4, 4.31% were classified by FIB4, with 60% agreement by FibroScan. Kappa statistic (0.1253) indicates slight agreement beyond chance, emphasizing caution when using these methods interchangeably. Table-1 compares FIB4 values and biopsy stages, showing moderate agreement, particularly for F4. Among 43 F0-1 cases by FIB4, 52.17% matched F0-1 biopsy, 38.24% were F2-3, and 11.63% were F4. For 68 F2-3 cases by FIB4, 16.18% were F0-1, 58.82% were F2-3, and 25.00% were F4. Among 5 F4 cases by FIB4, none were F0-1, 40.00% were F2-3, and 60.00% confirmed F4 by biopsy. Table-1 also correlates FibroScan and biopsy stages. Of 17 F0-1 cases by FibroScan, 64.71% matched biopsy, 35.29% were F2-3, none F4. Among 55 F2-3 cases by FibroScan, 16.36% were F0-1, 74.55% F2-3, 9.09% F4. Of 44 F4 cases by FibroScan, 6.82% were F0-1, 47.73% F2-3, and 45.45% confirmed F4 by biopsy. Significant F2-3 agreement, some F0-1 and F4 discrepancies were observed. Conclusion: Both FIB-4 and FibroScan showed a correlation with liver fibrosis, particularly in moderate fibrosis. However, discrepancies exist across different stages, with better performance in moderate fibrosis. Caution is advised when using non-invasive tests interchangeably with biopsy for fibrosis assessment in MASLD patients.

Volume

80

First Page

S452

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