1. What is LiverFASt?

LiverFASt is a non-invasive diagnostic and staging tool for the most common liver diseases; Hepatitis B, Hepatitis C, Non-alcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic Steatohepatitis (NASH). It utilizes the results of biomarkers from the blood test together with gender, age, weight and height to generate a combination of three scores which are correlated to the degree of liver damage: fibrosis, necroinflammatory activity and steatosis.

2. What are the biomarkers required for LiverFASt?

Biomarkers are alpha2-macroglobulin, haptoglobin, apolipoprotein A1, total bilirubin, γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting glucose, total cholesterol and triglycerides.

3. What is LiverFACt?

LiverFACt is a non-invasive diagnostic and staging tool that combines the results of 6 biomarkers, alpha2-macroglobulin, haptoglobin, apolipoprotein A1, total bilirubin, γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT) including patient’s age and gender to generate the score for fibrosis and necroinflammatory activity in the liver.

4. What is SteatoTEST?

SteatoTEST measures hepatic steatosis which is an accumulation of lipids in the liver cells (hepatocytes). The steatosis score is calculated using the biochemical markers from LiverFASt together with patient’s age, gender, weight and height.

5. How does it work?

6. What are the benefits of the test?

  • Recommended by the European EASL, APASL, WHO guidelines.
  • High applicability: more than 98% (even obese patients can use the test).
  • 100% of specificity = no risk of false positive because we use a security algorithm.
  • Very good inter-laboratory reproducibility.
  • Can be performed in clinic (outpatient no machine required).
  • Can be repeated easily for follow up purpose.
  • The most widely used and validated tests.

7. What are the limitations/ precautions for use of LiverFASt?

  • Acute hepatitis (acute viral hepatitis A, B, C, D, E; drug-induced hepatitis).
  • Extrahepatic cholestasis (pancreatic cancer, gallstones).
  • Severe hemolysis.
  • Gilbert's syndrome with high unconjugated hyperbilirubinemia.
  • Acute inflammatory syndrome -> the blood test just needs to be postponed.

8. What is Liver biopsy?

It is a procedure that a small needle is inserted into the liver to collect a tissue sample. Pathologist then examines the tissue under a microscope to diagnose a variety of disorders and diseases in the liver.

9. The comparison of LiverFASt vs Biopsy

LiverFASt Biopsy
Cost effective and non-invasive procedure Costly and invasive procedure
No complications Possible life threatening complications such as bleeding and infection
No hospitalization can be performed in an outpatient clinic. May require hospitalization
No Interobserver variation Interobserver variation (1)
Require only a simple blood test Require sufficiently trained physicians and pathologists
Can be used for screening and easy to repeat or follow up the disease condition Limited use for mass screening
High applicability of 98% even for obese and overweight patients Specimen sample taken may not be representative of the whole liver

10. What is Transient Elastrography?

Transient Elastography (TE) is a non-invasive test which measures the velocity of a low frequency elastic shear wave propagating through the liver. The velocity is then directly related to tissue stiffness. It is known and marketed under the brand name “Fibroscan”.

11. 7. The comparison of LiverFASt vs TE

LiverFASt Transient Elastrography
Better applicability (98%) Applicability (80%) lower than LiverFASt e.g. not suitable for the case of obesity, ascites, and operator experience)
Better specificity for both earlier stages (F1/F2) and later stages (F3/F4) Less specificity for early stages (F1/F2)
No variability Variability with risks of false positive in case of acute hepatitis, extrahepatic cholestasis, liver congestion, food intake and excessive alcohol intake.