Review
Copyright ©The Author(s) 2020.
World J Gastroenterol. Oct 21, 2020; 26(39): 5919-5943
Published online Oct 21, 2020. doi: 10.3748/wjg.v26.i39.5919
Table 1 Diagnostic performance of blood tests and scores for fibrosis assessment methods from studies made in patients with non-alcoholic fatty liver disease
Population (n)Ref.CutoffsSeSpPPVNPVAUROC
FIB-4 (age, platelet count, AST and ALT)541[52]≤ 1.3 NF74%71%43%90%0.802
≥ 2.67 AF33%98%80%83%
153[53]≥ 1.3 AF87%60%NANA0.895
452[56]≥ 1.5 AF75%67%58%82%0.780
328[57]≤ 1.3 NF56%56%22%85%0.540
≥ 2.67 AF22%87%27%84%
APRI (AST and platelet count)153[53]> 1 AF78%82%NANA0.830
> 2 AF28%92%NANA
452[56]> 0.559 AF62%76%61%76%0.754
NFS (age, glycaemia, BMI, platelet count, albumin, AST and ALT)480[55]≤ -1.455 NAF82%77%56%93%0.820
≥ 0.676 AF51%98%90%85%
126[58]≤ -1.455 NAF; ≥ 0.676 AF96%84%70%98%0.919
138[59]≤ -1.455 NAF22%100%100%81%0.680
≥ 0.676 AF
452[56]> -1.036 AF77%60%54%81%0.732
328[57]≤ -1.455 NAF53%67%26%87%0.640
122[61]≥ 0.676 AF9%98%50%83%0.840
NANA59%89%
BARD (BMI > 28 kg/m2, AST/ALT ratio > 0.8 and diabetes)126[58]0-1 NAF89%89%69%97%0.919
2-4 AF
138[59]0-1 NAF51%77%45%81%0.670
2-4 AF
160[60]0-1 NAFNANA27%97%0.780
2-4 AF
452[56]2-4 AF79%51%50%80%0.695
122[61]2-4 AFNANA59%77%0.730
328[57]2-4 AF83%37%22%91%0.594
Fibrometer NAFLD452[56]≥ 0.311 AF80%62%56%83%0.817
Hepascore (age, sex, bilirubin, GGT, hyaluronic acid, and a2-macroglobulin)452[56]≥ 0.322 AF67%76%63%79%0.778
Fibrotest (α-2-macroglobulin, haptoglobin, apolipoprotein A1, GGT, and TB)452[56]≥ 0.316 AF81%57%54%83%0.736
HFS (sex, age, HOMA score, diabetes, AST, albumin, and platelets)2452[69]< 0.12 NAF73.9%77.4%46%91.9%0.848
≥ 0.47 AF35.2%97.2%76.3%85.2%
49[70]≥ 0.47 AF11%100%100%83%NA
Table 2 Diagnostic performance of imaging studies for fibrosis assessment methods from studies made in patients with non-alcoholic fatty liver disease
PopulationRef.CutoffsSeSpPPVNPVAUROC
TE [LSM (kPA)]n = 291[85]≥ 8.2 kPa AF90%61%NANA0.870
≥ 12.5 kPa AF57%90%NANANA
452[56]≥ 8.7 kPa AF88%63%59%90%0.831
142[77]≥ 11.7 kPa AF86%84%75%92%0.880
79[83]≥ 9.5 kPa AF92%63%54%94%NA
MRE [LSM (kPA)]142[77]≥ 4.8 kPa AF74%87%74%81%0.890
628[63]≥ 3.6 kPa AF86%91%71%93%NA
117[97]≥ 3.63 kPa AF81%89%68%97%NA
142[98]≥ 4.15 kPa AF85%92%NANA0.954
102[99]> 3.64 kPa AF92%90%NANA0.957
ARFI [SWV (m/s)]291[85]≥ 1.15 AF90%63%NANA0.840
≥ 1.53 AF59%90%NANANA
57[90]≥ 1.45 AF76%68%NANA0.910
32[91]≥ 1.3 AF85%83%NANANA
23≥ 1.47 AF100%75%NANA0.942
NASH[92]
54[93]≥ 1.77 AF100%91%NANA0.930