TY  - JOUR
KW  - Non-invasive test
KW  -  fibroscan
KW  -  elastography
KW  -  compensated advanced
chronic liver disease
KW  -  diagnostic accuracy
PB  - Elsevier BV
ID  - discovery10192883
N2  - Background & Aims:
Agile scores, including liver stiffness measurements (LSM) and routine clinical/laboratory biomarkers, have been developed for advanced fibrosis (F?3) and cirrhosis (F4), respectively, in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). We independently validated the diagnostic accuracy of these scores in MASLD, alcohol-related liver disease (ALD) and chronic hepatitis B or C (CHB/C) and assessed them in clinical algorithms with FIB-4 and LSM.
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Methods:
We included 4,243 patients (MASLD: 912, ALD: 386, CHB: 597, CHC: 2,348) with LSM, liver biopsy and laboratory tests within 6 months. FIB-4, Agile 3+ and Agile 4 scores were calculated.
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Results:
For F?3, the diagnostic accuracy of Agile 3+ and LSM were similar in MASLD (AUC: 0.86 vs. 0.86, p = 0.831) and ALD (0.92 vs. 0.94, p = 0.123). For cirrhosis, Agile 4 was similar to LSM in MASLD (0.89 vs. 0.90, p = 0.412) and ALD (0.94 vs. 0.95, p = 0.513). Agile 3+/4 performed worse than LSM in CHB/C. Using predefined dual thresholds of 90% sensitivity/specificity, correct classification rates in MASLD were 66% vs. 61% using Agile 3+ vs. LS dual cut-offs and 71% vs. 67% in ALD, respectively. When using Agile 3+ or LSM as a second step after FIB-4 >1.3, correct classification rates were higher with Agile 3+ than LSM, both for MASLD (75% vs. 71%) and ALD (76% vs. 72%), with fewer indeterminate results. Positive agreement of LSM and Agile 3+/4 significantly increased the specificity of a diagnosis of advanced fibrosis/cirrhosis.
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Conclusion:
Agile 3+ and Agile 4 have equal diagnostic accuracy with LSM in both MASLD and ALD but result in fewer indeterminate results. Sequential use of FIB-4 and Agile 3+/4 or concurrent Agile 3+/4 and LSM can be used to further optimize F?3 diagnosis.
EP  - 599
AV  - restricted
Y1  - 2024/10//
TI  - Agile scores in MASLD and ALD: External validation and their utility in clinical algorithms
A1  - Papatheodoridi, Margarita
A1  - De Ledinghen, Victor
A1  - Lupsor-Platon, Monica
A1  - Bronte, Fabrizio
A1  - Boursier, Jerome
A1  - Elshaarawy, Omar
A1  - Marra, Fabio
A1  - Thiele, Maja
A1  - Markakis, Georgios
A1  - Payance, Audrey
A1  - Brodkin, Edgar
A1  - Castera, Laurent
A1  - Papatheodoridis, George
A1  - Krag, Aleksander
A1  - Arena, Umberto
A1  - Mueller, Sebastian
A1  - Cales, Paul
A1  - Calvaruso, Vincenza
A1  - Delamarre, Adele
A1  - Pinzani, Massimo
A1  - Tsochatzis, Emmanuel A
JF  - Journal of Hepatology
SN  - 0168-8278
UR  - http://dx.doi.org/10.1016/j.jhep.2024.05.021
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
IS  - 4
SP  - 590
VL  - 81
ER  -