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Abstract #4749

Performance of non-invasive biomarkers in identifying patients with at-risk metabolic dysfunction-associated steatohepatitis

Jiahui Li1, Alina M Allen2, Taofic Mounajjed3, Rondell Graham3, Kevin J. Glaser1, Armando Manduca1, Sudhakar K. Venkatesh1, Claude Sirlin4, Vijay H. Shah2, Richard L. Ehman1, Rohit Loomba4, and Meng Yin1
1Radiology, Mayo Clinic, Rochester, MN, United States, 2Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States, 3Anatomic Pathology, Mayo Clinic, Rochester, MN, United States, 4UC San Diego Medical Center, San Diego, CA, United States

Synopsis

Keywords: Liver, Elastography

Motivation: MRE-assessed liver stiffness, MRI-derived fat fraction, AST, and FIB-4 are promising predictors for identifying at-risk MASH, which is defined as MASH with fibrosis stage 2 or higher. Some investigators have also proposed an additional criterion, NAS ≥ 4 with at least 1 point in each category.

Goal(s): Assess prediction models for diagnostic accuracy in identifying at-risk MASH under both definitions.

Approach: AUC and its 95% confidence intervals were used to assess the overall diagnostic accuracy.

Results: The additional criterion influenced the performance of prediction models, but liver stiffness remains the most reliable single predictor among non-invasive biomarkers.

Impact: At-risk MASH is defined as a MASH diagnosis with fibrosis stage ≥2. Adding a criterion of NAS≥4 with ≥1 point in each category impacts diagnostic accuracy but liver stiffness remains the most reliable single predictor.

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Keywords