What question did this study set out to answer?

This study aims to compare the effectiveness of LIVERFASt versus FIB-4, each combined with VCTE, in identifying advanced fibrosis in MASLD patients.

June 7, 2026

1780-P: LIVERFAST Outperforms FIB-4 in Sequential Combination with Vibration Controlled Transient Elastography (VCTE) for Identifying ≥F3 Stage in Patients with MASLD Including Patients with Type 2 Diabetes

Puntos clave

This study aims to compare the effectiveness of LIVERFASt versus FIB-4, each combined with VCTE, in identifying advanced fibrosis in MASLD patients.
Included MASLD patients from a tertiary hepatology center assessed with LIVERFASt, FIB-4, VCTE, and liver biopsy within 6 months.
Evaluated performance metrics such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
LIVERFASt showed almost twice the sensitivity compared to FIB-4 for ≥F3 fibrosis, especially at high FIB-4 cut-offs.
The combination of LIVERFASt and VCTE achieved a higher PPV of 90.4% compared to 76% for FIB-4 and VCTE.
Biopsy confirmed LIVERFASt results more frequently than FIB-4 in discordant VCTE cases.

Resumen

Introduction and Objective: FIB-4 followed by VCTE is recommended to detect advanced fibrosis (≥F3). LIVERFASt (Fibronostics U.S, Inc.) is a novel blood-based test reimbursed to identify liver fibrosis in US.The study aimed to compare the performance of LIVERFASt and FIB-4, sequentially with VCTE, for the identification of ≥F3 fibrosis including analyses in patients with type 2 diabetes (T2DM). Methods: This retrospective study included MASLD patients from a tertiary hepatology center with LIVERFASt, FIB-4, VCTE, and liver biopsy within 6-month. Performances were assessed using sensitivity, specificity, PPV, NPV, and number needed to diagnose (NND). Results: LIVERFASt outperformed FIB-4 for identifying ≥F3 fibrosis, showing almost twice higher sensitivity and higher NPV at the high FIB-4 cut-off (2.67) and higher specificity and PPV at the recommended cut-off (≥1.3 2.0). The combination LIVERFASt and VCTE achieved higher PPV (90.4%) than FIB-4 and VCTE (76%) with similar NPV. In discordant cases with VCTE, biopsy confirmed LIVERFASt more often than FIB-4. In the T2DM subgroup, LIVERFASt identified a similar number of ≥F3 cases as FIB-4 but required significantly fewer VCTE referrals. Conclusion: LIVERFASt outperformed FIB-4 and its integration into MASLD pathways may enhance screening efficiency, including in high-risk T2DM patients. Disclosure M. Decraecker: None. J. Hiriart: None. M. Irles-Depe: None. J. Foucher: None. J. Hu: Employee; Current; Fibronostics. R. Quiambao: Employee; Current; Fibronostics. A. Asgharpour: None. M. Munteanu: Employee; Current; FIBRONOSTICS. V. DeLedinghen: Employee; Current; Echosens. Research Support; Ended; Fibronostics.

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