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Updated: May 28, 2026
06:09
A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography
Published on: July 21, 2023
Cut or Count? Evaluating Advanced Fibrosis Assessment Tools in MASH and Chronic Viral Hepatitis
Ivana Milošević1,2, Branko Beronja1, Nada Tomanović3
1Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, Bulevar Oslobođenja 16, 11000 Belgrade, Serbia.
Biomedicines
|May 27, 2026
Summary
Non-invasive fibrosis markers like NFS and FIB-4 for MASH, and transient elastography (TE) for chronic viral hepatitis (CVH), effectively detect advanced liver fibrosis. These tools can reduce the need for invasive liver biopsies, especially in high-risk patients.
Area of Science:
- Hepatology and Gastroenterology
- Diagnostic Imaging and Biomarkers
- Non-invasive Disease Assessment
Background:
- Chronic liver diseases, including metabolic dysfunction-associated steatohepatitis (MASH) and chronic viral hepatitis (CVH), pose significant global health risks, potentially leading to cirrhosis and liver cancer.
- Liver biopsy, the current gold standard for diagnosing fibrosis, is invasive and carries risks, driving the need for reliable non-invasive assessment tools.
- Accurate staging of liver fibrosis is crucial for patient management and treatment decisions in MASH and CVH.
Purpose of the Study:
- To compare the diagnostic performance of multiple non-invasive fibrosis markers and transient elastography (TE) in identifying advanced liver fibrosis (F4) in patients with MASH and CVH.
- To evaluate the utility of serum fibrosis indices (ARR, APRI, FI, FIB-4, API, NFS, BARD) and TE against histological staging.
Main Methods:
- A retrospective study of 237 adult patients (77 MASH, 160 CVH including CHB and CHC) who underwent liver biopsy.
- Patients were assessed using various serum fibrosis indices and TE, with results compared to histological fibrosis staging (F0-F4).
- Receiver Operating Characteristic (ROC) curve analysis was employed to determine the diagnostic performance of each non-invasive method.
Main Results:
- Advanced fibrosis (F4) was more prevalent in CVH patients compared to MASH patients (p < 0.001).
- In MASH, NFS (AUROC 0.931) and FIB-4 (0.915) demonstrated high accuracy for detecting F4.
- For CHC, APRI (0.931) and TE (0.938) showed strong performance, while TE (0.987) significantly outperformed FIB-4 (0.821) in CHB patients.
Conclusions:
- Non-invasive methods, specifically NFS and FIB-4 for MASH and TE for CVH, are effective in identifying advanced liver fibrosis.
- The application of these non-invasive tools can substantially decrease the reliance on liver biopsy, particularly in high-risk patient populations.
- While TE offers superior accuracy, its limited accessibility underscores the continued clinical importance of serum-based fibrosis scores.
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