The accuracy of available non-invasive tools for staging severe fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) is still limited.
Dr Petta and colleagues from Italy assessed the diagnostic performance of paired or serial combination of non-invasive tools in NAFLD patients.
The research team analyzed data from 741 patients with a histological diagnosis of NAFLD.
The GGT/PLT, APRI, AST/ALT, BARD, FIB-4, and NAFLD Fibrosis Score scores were calculated according to published algorithms.
Liver stiffness measurement was performed by FibroScan.
|A low NAFLD Fibrosis Score increased the diagnostic accuracy ranging from 69% to 70%|
|Alimentary Pharmacology & Therapeutics|
The researchers found that liver stiffness measurement, NAFLD Fibrosis Score and FIB-4 were the best non-invasive tools for staging F3-F4 fibrosis, with liver stiffness measurement having the highest sensitivity, and the highest NPV, and NAFLD Fibrosis Score and FIB-4 the highest specificity, and the highest PPV.
The paired combination of liver stiffness measurement or NAFLD Fibrosis Score with FIB-4 strongly reduced the likelihood of wrongly classified patients, at the price of a high uncertainty area, and of a low overall accuracy.
The research team noted that serial combination with the second test used in patients in the grey area of the first test.
The team observed that in those with high liver stiffness measurement values or low NAFLD Fibrosis Score or FIB-4 values overall increased the diagnostic performance generating an accuracy ranging from 69% to 70%, an uncertainty area ranging from 19% to 20% and a rate of wrong classification ranging from 9% to 11%.
Dr Petta's team comments, "The serial combination of liver stiffness measurement with FIB-4/NAFLD Fibrosis Score has a good diagnostic accuracy for the non-invasive diagnosis of severe fibrosis in NAFLD."