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Review
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- Role of noninvasive tests in the prognostication of metabolic dysfunction-associated steatotic liver disease
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Yue Wang1,2, Sherlot Juan Song1,2, Yichong Jiang1,2, Jimmy Che-To Lai1,2, Grace Lai-Hung Wong1,2, Vincent Wai-Sun Wong1,2, Terry Cheuk-Fung Yip1,2
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1Medical Data Analytic Center, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
2State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Corresponding author: Vincent Wai-Sun Wong ,Email: wongv@cuhk.edu.hk
Terry Cheuk-Fung Yip ,Email: tcfyip@cuhk.edu.hk
- Received: April 10, 2024; Revised: June 20, 2024 Accepted: June 26, 2024.
- Abstract
- In managing metabolic dysfunction-associated steatotic liver disease, which affects over 30% of the general population, effective noninvasive biomarkers for assessing disease severity, monitoring disease progression, predicting the development of liver-related complications, and assessing treatment response are crucial. The advantage of simple fibrosis scores lies in their widespread accessibility through routinely performed blood tests and extensive validation in different clinical settings. They have shown reasonable accuracy in diagnosing advanced fibrosis and good performance in excluding the majority of patients with a low risk of liver-related complications. Among patients with elevated serum fibrosis scores, a more specific fibrosis and imaging biomarker has proved useful to accurately identify patients at risk of liver-related complications. Among specific fibrosis blood biomarkers, enhanced liver fibrosis is the most widely utilized and has been approved in the United States as a prognostic biomarker. For imaging biomarkers, the availability of vibration-controlled transient elastography has been largely improved over the past years, enabling the use of liver stiffness measurement (LSM) for accurate assessment of significant and advanced fibrosis, and cirrhosis. Combining LSM with other routinely available blood tests enhances the ability to diagnose at-risk metabolic dysfunction-associated steatohepatitis; and predict liver-related complications, some reaching an accuracy comparable to that of liver biopsy. Magnetic resonance imaging-based modalities provide the most accurate quantification of liver fibrosis, though the current utilization is limited to research settings. Expanding their future use in clinical practice depends on factors such as cost and facility availability.
Keywords :MASLD; metabolic-associated fatty liver disease; nonalcoholic fatty liver disease; cirrhosis; hepatocellular carcinoma; hepatic decompensation
