A Combination Of Non-Invasive Tests In Detection Of NAFLD-Related Advanced Fibrosis Is Not Superior To MRE Alone

Background and Aims The superiority of combination of non-invasive tests for assessment of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) is unclear. The aims of the present study were to investigate the superiority of combination of magnetic resonance elastography (MRE) and transient elastography (TE) or MRE and FIB-4 index or MRE alone in the detection of advanced fibrosis in patients with NAFLD. Methods 119 consecutive patients with NAFLD were included into analysis. Histological samples were interpreted using NASH CRN Scoring system. Liver stiffness was measured by vibration-controlled TE using a FibroScan probe (Echosens, Paris, France) and MRE with a 1.5-T MR system. Advanced fibrosis was defined as≥stage 2 fibrosis. The cut-off points for MRE, TE and FIB-4 index for advanced fibrosis were 3.2 kPa, 9.0 kPa and 1.6, respectively. Results The mean age of patients was 53 years. Sixty-five patients (55%) diagnosed with stage 2 fibrosis. The median interval between MRE and liver biopsy was 30 days. MRE, TE and FIB-4 index demonstrated a significant accuracy for the detection of significant fibrosis ( p=<0.001, 0.014 and 0.014, respectively). MRE, TE and FIB-4 index demonstrated significant accuracy with an AUROC of 0.848±0.036 (p<0.001), 0.632±0.052 (p=0.012) and 0.664±0.051 (p=0.001), respectively. Diagnostic performance of MRE was superior than TE (p<0.001) and FIB-4 index (p=0.001). A combination MRE and TE or MRE and FIB-4 index were not superior than MRE alone (p=0.880 and p=0.45, respectively). Conclusion MRE alone is accurately used for non-invasive Publication History Article published online: 18 January 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany