Non-invasive testing and risk-stratification in patients with MASLD

Eur J Intern Med. 2024 Apr:122:11-19. doi: 10.1016/j.ejim.2024.01.013. Epub 2024 Jan 20.

Abstract

The development and validation of non-invasive fibrosis tests (NITs) has changed clinical practice in Hepatology over the last 15 years. Metabolic associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is the most prevalent liver disease in western countries, with up to a third of the unselected adult population affected. In this article, we review the use of NITs in the diagnosis and staging of MASLD. We discuss their use in the diagnosis of steatosis, steatohepatitis and fibrosis and critically evaluate recently published data. These NITs include a variety of approaches, such as serum markers like FIB-4, pro-C3 and ELF, imaging techniques like Fibroscan® and MRE, and combined scores like Agile 3+ and Agile 4, offering a range of options for healthcare providers. Furthermore, these non-invasive tests also serve as valuable prognostic tools, allowing for better risk assessment and improved patient management, particularly in predicting liver-related events and overall mortality.

Keywords: Cirrhosis; ELF; FIB4; Fibroscan; NAFLD.

Publication types

  • Review

MeSH terms

  • Adult
  • Elasticity Imaging Techniques*
  • Health Personnel
  • Humans
  • Liver Cirrhosis / diagnosis
  • Metabolic Diseases*
  • Non-alcoholic Fatty Liver Disease* / diagnosis