1. M‐PAST score is better than MAST score for the diagnosis of active fibrotic nonalcoholic steatohepatitis
- Author
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Imajo, Kento, Saigusa, Yusuke, Kobayashi, Takashi, Nagai, Koki, Nishida, Shinya, Kawamura, Nobuyoshi, Doi, Hiroyoshi, Iwaki, Michihiro, Nogami, Asako, Honda, Yasushi, Kessoku, Takaomi, Ogawa, Yuji, Kirikoshi, Hiroyuki, Yasuda, Satoshi, Toyoda, Hidenori, Hayashi, Hideki, Kokubu, Shigehiro, Utsunomiya, Daisuke, Takahashi, Hirokazu, Aishima, Shinichi, Kim, Beom Kyung, Tamaki, Nobuharu, Saito, Satoru, Yoneda, Masato, Loomba, Rohit, and Nakajima, Atsushi
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Hepatitis ,Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Clinical Research ,Liver Disease ,active fibrotic NASH ,F-CAST ,FAST ,M-PAST ,MAST ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
BackgroundClinical trials enroll patients with active fibrotic nonalcoholic steatohepatitis (NASH) (nonalcoholic fatty liver disease [NAFLD] activity score ≥ 4) and significant fibrosis (F ≥ 2); however, screening failure rates are high following biopsy. We developed new scores to identify active fibrotic NASH using FibroScan and magnetic resonance imaging (MRI).MethodsWe undertook prospective primary (n = 176), retrospective validation (n = 169), and University of California San Diego (UCSD; n = 234) studies of liver biopsy-proven NAFLD. Liver stiffness measurement (LSM) using FibroScan or magnetic resonance elastography (MRE), controlled attenuation parameter (CAP), or proton density fat fraction (PDFF), and aspartate aminotransferase (AST) were combined to develop a two-step strategy-FibroScan-based LSM followed by CAP with AST (F-CAST) and MRE-based LSM followed by PDFF with AST (M-PAST)-and compared with FibroScan-AST (FAST) and MRI-AST (MAST) for diagnosing active fibrotic NASH. Each model was categorized using rule-in and rule-out criteria.ResultsAreas under receiver operating characteristic curves (AUROCs) of F-CAST (0.826) and M-PAST (0.832) were significantly higher than those of FAST (0.744, p = 0.004) and MAST (0.710, p
- Published
- 2023