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. 2024 Jun 7;17(4):374–444. doi: 10.1159/000539371

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© 2024 The Author(s). Published by Elsevier BV on behalf of European Association for the Study of the Liver (EASL) and by S Karger AG.

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Fig. 2. — Proposed strategy for non-invasive assessment of the risk for advanced fibrosis and liver-related outcomes in individuals with metabolic risk factors or signs of SLD. Individuals with (A) T2D or (B) abdominal obesity and ≥1 additional cardiometabolic risk factor(s) or (C) persistently elevated liver enzymes should undergo a multi-step diagnostic process, as indicated in the figure, to identify individuals with MASLD and advanced fibrosis. The algorithm can also be applied in case of incident finding of steatosis. This strategy is intended to identify individuals at risk of developing liver-related outcomes. ELF, enhanced liver fibrosis; FIB-4, fibrosis-4 index; GLP1RA, glucagon-like peptide-1 receptor agonist; MRE, magnetic resonance elastography; SLD, steatotic liver disease; SWE, shear wave elastography; VCTE, vibration-controlled transient elastography.