Non-invasively differentiate non-alcoholic steatohepatitis by visualizing hepatic integrin αvβ3 expression with a targeted molecular imaging modality

Table 1 Summary characteristics of different non-invasive methods[31-36]

Methods			Advantages	Flaws	Patients (n)	AUROC		Sensitivity (%)	Specificity (%)
Imaging modalities	Quantitative ultrasound biomarkers	Ultrasound attenuation coefficient[31]	Low cost and wide availability; High sensitivity and specificity in grading	The diagnostic performance is affected by the presence of fibrosis.	125 (Excluding liver fibrosis)	S0 vs S1, S2, S3	0.951	82.1	95.5
						S0, S1 vs S2, S3	0.987	94.3	93.9
						S0, S1, S2 vs S3	0.931	94.1	85.5
		Ultrasound-derived fat fraction[32]	Low cost and wide availability; Real-time data collection	High interobserver variability	46	S0 vs S1, S2, S3	0.950	90.0	94.0
						S0, S1 vs S2, S3	0.980
	CT	Contrast-enhanced CT[33]	Common in clinical practice; Quantify liver fat without additional radiation exposure	Exposes patients to ionizing radiation	1204	Steatosis≥ 5%	0.669	34.0	94.2
						Steatosis≥ 10%	0.854
						Steatosis ≥ 15%	0.962	75.9	95.7
		Non-contrast dual-energy CT[34]	Reliable for detection of moderate steatosis	Influenced by varying contrast bolus and scan timing, cardiac output	128	Right lobe	0.834	57.0	94.0
						Left lobe	0.872	68.0	90.0
	MR-PDFF[35]		It is used as a reference for testing other clinical or biochemical markers	Expensive; availability-limited; unable to assess liver inflammation, ballooning	77	S0 vs S1, S2, S3	0.989	97	100
						S0, S1 vs S2, S3	0.825	61	90
						S0, S1, S2 vs S3	0.893	68	91
Serum biomarkers	Laboratory parameter-based model	NAFLD bridge score[36]	Data availability and cost-effectiveness	Unable to differentiate NASH from simple steatosis with high sensitivity and specificity	422	With and without NAFLD	0.880	95	87

MR-PDFF: Magnetic resonance imaging-estimated proton density fat fraction; AUROC: Area under the receiver operating characteristic curve; CT: Computed tomography; NAFLD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis.