Fibrosis-4 and Fibrosis-5 scores in predicting functional liver imaging score

Hepatic fibrosis can be predicted using fibrosis-4 (FIB-4) and fibrosis-5 (FIB-5) scores. Functional liver imaging score (FLIS) provides valuable information regarding hepatic function. We aimed to assess whether easily obtained blood parameters (FIB-4 and FIB-5) may be used to discriminate preserved and impaired hepatic function based on FLIS.

Patients who underwent dynamic upper abdominal MRI with gadoxetic acid were retrospectively reviewed (n = 101, mean age 61.0 ± 11.3 years). FLIS values were categorized as FLIS < 4 (impaired hepatic function) and FLIS ≥ 4 (preserved hepatic function). The discriminative potential of FIB-4 and FIB-5 was assessed by plotting ROC curves.

While FIB-4 was significantly higher, FIB-5 was significantly lower in patients with FLIS < 4. They had significant discriminative value in distinguishing patients with preserved and impaired hepatic function (area under the ROC curves 0.794 for FIB-4 and 0.748 for FIB-5, p-values < 0.001). Comparison of the area under the 2 ROC curves revealed that FIB-4 and FIB-5 had similar discriminative values (p = 0.405). For FIB-4, a cut-off value of 4.2 had a sensitivity of 88.9%, specificity of 66.3%, PPV of 20.5%, and NPV of 98.4%, meaning that FIB-4 values of < 4.2 are valuable in ruling out FLIS < 4 (poor hepatic function). For FIB-5, a cut-off value of 36.2 had a sensitivity of 88.9%, specificity of 60.9%, PPV of 18.2%, and NPV of 98.2%, meaning that FIB-5 values of > 36.2 are valuable in ruling out FLIS < 4.

FIB-4 and FIB-5 are valuable in discriminating preserved and impaired hepatic function based on FLIS scoring with similar diagnostic performance.