Liver Biopsy had been the Gold standard for staging of liver steatosis and fibrosis. FibroScan is a recent advancement of non invasive imaging came along with LSM and CAP score. Based on several studies, LSM score is reflecting closely to METAVIR staging system for liver fibrosis. May I know what is the most commonly use staging system for steatosis where CAP score could reference to? I found Kleiner Classification and NAFLD score, however I am unsure which is the accurate system.
Hi Kevin, Different scoring systems are used in literature. Most scoring systems report on steatosis and inflammation, such as the NAFLD activity score (NAS) (Kleiner et al. Hepatology 2005) and the Brunt scoring system (Brunt et al. 1999) and the SAF score (steatosis, activity, fibrosis) (Bedossa et al. Hepatology 2012). However, it is important to know that the scoring for the feature steatosis, is all the same: grade 0-3 based on percent of hepatocytes in the biopsy involved (0 is none; 1 is up to 33%; 2 is 33-66%; 3 is >66%). So studies that report on the accuracy of CAP, and since CAP measures liver steatosis, use this grading system for steatosis. For example: De Lédinghen et al. Non-invasive diagnosis of liver steatosis using controlled attenuation parameter (CAP) and transient elastography. Liver int. 2012.
Is this an answer to your question?
Laura Draijer Hi, Thank you so much for clearing my doubt. Yes, I had read through Kleiner et al 2005 & Burnt et al. 1999. I think CAP score is referencing either one of their staging system since they share the same feature. Again, I appreciate your response. Have a good day.
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