TABLE 2.

Confounders and limitations of each noninvasive modality for liver fibrosis

	Confounders	Limitation
Blood-based marker
FIB-4, NAFLD fibrosis score	Age, acute hepatitis, systemic inflammation	The diagnostic accuracy decreases in elderly or younger patients Age-specific thresholds are needed
M2BPGi	Viral hepatitis, systemic inflammation	Etiology-specific thresholds are needed
ELF, PRO-C3	Other fibrotic diseases	Validation studies are limited
Imaging-based marker
VCTE	Obesity, food intake, acute hepatitis, systemic inflammation	The diagnostic accuracy decreases in patients with obesity Obesity specific probe can be used but the compatibility between probes is not fully evaluated
pSWE, 2D-SWE	Food intake, acute hepatitis, systemic inflammation	Validation studies are limited
MRE	Contraindications to MRI, iron overload	High cost and low availability

Abbreviations: 2D-SWE, two-dimensional shear wave elastography; ELF, enhanced liver fibrosis; M2BPGi, mac-3 binding protein glycosylation isomer; MRE, magnetic resonance elastography; PRO-C3, N-terminal propeptide of type 3 collagen; pSWE, point shear wave elastography; VCTE, vibration-controlled transient elastography.