ArticleHepatology research : the official journal of the Japan Society of Hepatology2023
M-PAST score is better than MAST score for the diagnosis of active fibrotic nonalcoholic steatohepatitis.
Article in Hepatology research : the official journal of the Japan Society of Hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 6 citations in OpenAlex.
- MAST versus FAST for active fibrotic MASH: a meta-analysis supporting risk-stratified diagnostic pathways.Frontiers in medicine · 2026Pooled it
- Accuracy of Non-Invasive Imaging Techniques for the Diagnosis of MASH in Patients With MASLD: A Systematic Review.Liver international : official journal of the International Association for the Study of the Liver · 2025Pooled it
- FibroScan-AST score for diagnosing fibrotic MASH: A systematic review and meta-analysis of diagnostic test accuracy studies.Journal of gastroenterology and hepatology · 2024Pooled it
- Simplified definition and imaging-based stratification of at-risk MASH using magnetic resonance elastography.Hepatology communications · 2026Article
- Diagnostic performance of ultrasound-derived fat fraction for grading hepatic steatosis in patients with chronic liver diseases: a multicenter study.European radiology · 2026Article
- Noninvasive strategies for metabolic dysfunction-associated steatotic liver disease assessment and referral in Japan.World journal of gastroenterology · 2026Review
- Guideline for the Prevention and Treatment of Metabolic Dysfunction-associated Fatty Liver Disease (Version 2024).Journal of clinical and translational hepatology · 2024Article
- [Guidelines for the prevention and treatment of metabolic dysfunction-associated (non-alcoholic) fatty liver disease (Version 2024)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- [Research advances in the non-invasive diagnosis of metabolic dysfunction-associated fatty liver disease based on magnetic resonance technology].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Review
- Magnetic resonance elastography combined with fibrosis-4 index for diagnosing at-risk metabolic dysfunction-associated steatohepatitis: a systematic review and meta-analysis of diagnostic test accuracy studies.Annals of gastroenterologyArticle
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Authors and funding
26 authors at 8 institutions in 2 countries.
Funding
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 < 0.001). Following the rule-in criteria, positive predictive values of F-CAST (81.8%) and M-PAST (81.8%) were higher than those of FAST (73.5%) and MAST (70.0%). Following the rule-out criteria, negative predictive values of F-CAST (90.5%) and M-PAST (90.9%) were higher than those of FAST (84.0%) and MAST (73.9%). In the validation and UCSD cohorts, AUROCs did not differ significantly between F-CAST and FAST, but M-PAST had a higher diagnostic performance than MAST.
conclusionsThe two-step strategy, especially M-PAST, showed reliability of rule-in/-out for active fibrotic NASH, with better predictive performance compared with MAST. This study is registered with ClinicalTrials.gov (number, UMIN000012757).
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