Liver Stiffness on Magnetic Resonance Elastography and the MEFIB Index and Liver-Related Outcomes in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Individual Participants

Ajmera, Veeral; Kim, Seung Up; Yang, Kun; Majzoub, Abdul M.; Nayfeh, Tarek; Tamaki, Nobuharu; Izumi, Namiki; Nakajima, Atsushi; İdilman, Ramazan; Gümüşsoy, Mesut; Öz, Diğdem Kuru; Erden, Ayşe; Quach, Natalie E.; Tu, Xin; Zhang, Xinlian; Noureddin, Mazen; Allen, Alina M.; Loomba, Rohit

doi:10.1053/j.gastro.2022.06.073

Cited by 86 publications

(78 citation statements)

References 38 publications

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“…46,47 The MEFIB index had a robust association with liver-related outcome with a hazard ratio of 20.6 (95% CI, 10.4-40.8) and the negative predictive value (NPV) for the outcome reached 99.1% at 5 years. 48 Future studies should explore if the dynamic change of MEFIB index correlated with liver-related outcomes.…”

Section: Mefibmentioning

confidence: 99%

Non-invasive biomarkers for liver inflammation in non-alcoholic fatty liver disease: present and future

Yip¹,

Lyu²,

Lin³

et al. 2023

Clin Mol Hepatol

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Terry Yip has served as a speaker and an advisory committee member for Gilead Sciences.Vincent Wong has served as an advisory committee member for AbbVie, Allergan, Echosens, Gilead Sciences, Janssen, Perspectum Diagnostics, Pfizer and Terns, and a speaker for Bristol-Myers Squibb, Echosens, Gilead Sciences and Merck.Grace Wong has served as an advisory committee member for Gilead Sciences and Janssen, as a speaker for Abbott,

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Section: Mefibmentioning

confidence: 99%

Non-invasive biomarkers for liver inflammation in non-alcoholic fatty liver disease: present and future

Yip¹,

Lyu²,

Lin³

et al. 2023

Clin Mol Hepatol

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“…Recently, noninvasive LS-based models combining two different biomarkers have shown promising results in identifying patients with significant liver fibrosis, with increased positive predictive value (PPV), thereby reducing screening failure rates in clinical trials and reducing unnecessary liver biopsies (67)(68)(69). In previous studies, MEFIB (MRE plus fibrosis-4 [FIB-4]) had a significantly higher diagnostic accuracy than MRE alone and the FIB-4 index alone (67).…”

Section: Detection and Staging Of Liver Fibrosismentioning

confidence: 99%

Noninvasive imaging biomarkers for liver fibrosis in nonalcoholic fatty liver disease: current and future

Yu¹,

Lee²,

Kim³

2023

Clin Mol Hepatol

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Nonalcoholic fatty liver disease (NAFLD) is increasingly prevalent worldwide and becoming a major cause of liver disease-related morbidity and mortality. The presence of liver fibrosis in patients with NAFLD is closely related to prognosis, including the development of hepatocellular carcinoma and other complications of cirrhosis. Therefore, assessment of the presence of significant or advanced liver fibrosis is crucial. Although liver biopsy has been considered the "gold standard" method for evaluating the degree of liver fibrosis, it is not suitable for extensive use in all patients with NAFLD owing to its invasiveness and high cost.Therefore, noninvasive biochemical and imaging biomarkers have been developed to overcome the limitations of liver biopsy. Imaging biomarkers for the stratification of liver fibrosis have been evaluated in patients with NAFLD using different imaging techniques, such as transient elastography, shear wave elastography, and magnetic resonance elastography. Furthermore, artificial intelligence and deep learning methods are increasingly being applied to improve the diagnostic accuracy of imaging techniques and overcome the pitfalls of existing imaging biomarkers. In this review, we describe the usefulness and future prospects of noninvasive imaging biomarkers that have been studied and used to evaluate the degree of liver fibrosis in patients with NAFLD.

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“…69 In addition to this, other combinations use lab tests and radiologic tests such as VCTE and AST (FAST), MRE and AST (MAST) and MRE and FIB-4 (MEFIB) score to risk stratify NAFLD patients. [70][71][72][73][74][75][76][77][78] The clinical utility and large-scale external validation studies of these combinations are still pending.…”

Section: Combination Nits For Fibrosismentioning

confidence: 99%

A practical use of noninvasive tests in clinical practice to identify high‐risk patients with nonalcoholic steatohepatitis

Younossi

Alkhouri

Cusi

et al. 2022

Aliment Pharmacol Ther

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Summary Background Patients with nonalcoholic fatty liver disease (NAFLD) with type 2 diabetes (T2D) or other components of metabolic syndrome are at high risk for disease progression. We proposed an algorithm to identify high‐risk NAFLD patients in clinical practice using noninvasive tests (NITs). Methods Evidence about risk stratification of NAFLD using validated NITs was reviewed by a panel of NASH Experts. Using the most recent evidence regarding the performance of NITs and their application in clinical practice were used to develop an easy‐to‐use algorithm for risk stratification of NAFLD patients seen in primary care, endocrinology and gastroenterology practices. Results The proposed algorithm uses a three‐step process to identify NAFLD patients who are potentially at high risk for adverse outcomes. The first step is to use clinical data to identify most patients who are at risk for having potentially progressive NAFLD (e.g. having T2D or multiple components of metabolic syndrome). The second step is to calculate the FIB‐4 score as a NIT that can further risk stratifying individuals who are at low risk for progressive liver disease and can be managed by their primary healthcare providers to manage their cardiometabolic comorbidities. The third step is to use second‐line NITs (transient elastography or enhanced liver fibrosis tests) to identify those who at high risk for progressive liver disease and should be considered for specially care by providers with NASH expertise. Conclusions The use of this simple clinical algorithm can identify and assist in managing patients with NAFLD at high risk for adverse outcomes.

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Liver Stiffness on Magnetic Resonance Elastography and the MEFIB Index and Liver-Related Outcomes in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Individual Participants

Cited by 86 publications

References 38 publications

Non-invasive biomarkers for liver inflammation in non-alcoholic fatty liver disease: present and future

Non-invasive biomarkers for liver inflammation in non-alcoholic fatty liver disease: present and future

Noninvasive imaging biomarkers for liver fibrosis in nonalcoholic fatty liver disease: current and future

A practical use of noninvasive tests in clinical practice to identify high‐risk patients with nonalcoholic steatohepatitis

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