Imaging-based modalities compared for identifying at-risk MASH

FibroScan-aspartate aminotransferase (FAST) demonstrated the highest sensitivity for ruling out at-risk metabolic dysfunction-associated steatohepatitis (MASH), according to a study published in the October issue of the American Journal of Gastroenterology.

Shyna Zhuoying Gunalan, from the National University of Singapore, and colleagues conducted a systematic review to identify studies reporting on magnetic resonance imaging (MRI)-based diagnostic techniques for at-risk MASH. The diagnostic performance of imaging-based technologies for ruling in (TRI) and ruling out (TRO) at-risk MASH was evaluated. Twenty studies, with 9,480 participants, met the inclusion criteria.

The researchers found that FAST demonstrated the highest TRO sensitivity, with moderate specificity (0.871 and 0.567, respectively); TRI specificity and sensitivity were 0.900 and 0.441, respectively. High TRO sensitivity was achieved with magnetic resonance elastography plus fibrosis-4, while specificity was lower (0.812 and 0.606, respectively); specificity and sensitivity for TRI were 0.872 and 0.500, respectively. Intermediate performance was achieved with MRI-aspartate aminotransferase, while variable diagnostic accuracy was seen for iron-corrected T1 mapping thresholds. Compared with other diagnostic methods, superior performance was seen in FAST in a sensitivity analysis of head-to-head studies.

“Given the findings, the FAST score may be the most practical option for wide-scale implementation, offering ease of access and a relatively lower cost compared with other diagnostic methods,” the authors write. “However, magnetic resonance-based technologies also provide strong evidence for the identification of at-risk MASH.”

Several authors disclosed ties to the biopharmaceutical industry.

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