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Background and Aim: SmartExam is a novel computational method compatible with FibroScan that uses a software called SmartDepth and continuous controlled attenuation parameter measurements to evaluate liver fibrosis and steatosis. This retrospective study compared the diagnostic accuracy of conventional and SmartExam‐equipped FibroScan for liver stiffness measurement (LSM). Methods: The liver stiffness and the associated controlled attenuation parameters of 167 patients were measured using conventional and SmartExam‐Equipped FibroScan as well as reference methods like magnetic resonance elastography (MRE) and magnetic resonance imaging‐based proton density fat fraction (MRI‐PDFF) measurements to assess its diagnostic performance. M or XL probes were selected based on the probe‐to‐liver capsule distance for all FibroScan examinations. Results: The liver stiffness and controlled attenuation parameter (CAP) correlation coefficients calculated from conventional and SmartExam‐equipped FibroScan were 0.97 and 0.82, respectively. Using MRE/MRI‐PDFF as a reference and the DeLong test for analysis, LSM and the area under the receiver operating characteristic curve for CAP measured by conventional and SmartExam‐equipped FibroScan showed no significant difference. However, the SmartExam‐equipped FibroScan measurement (33.6 s) took 1.4 times longer than conventional FibroScan (23.2 s). Conclusions: SmartExam has a high diagnostic performance comparable with that of conventional FibroScan. Because the results of the conventional and SmartExam‐equipped FibroScan were strongly correlated, it can be considered useful for assessing the fibrosis stage and steatosis grade of the liver in clinical practice, with less variability but little longer measurement time compared with the conventional FibroScan. [ABSTRACT FROM AUTHOR]

Background and Aims: The Baveno VI criteria enable non‐invasive screening for esophageal varices. However, these criteria were established based on studies examining a large proportion of patients with viral hepatitis and relatively few patients with non‐alcoholic fatty liver disease (NAFLD). Furthermore, because vibration‐controlled transient elastography (VCTE) has a high incidence of measurement error, improved criteria are needed. We aimed to develop criteria based on magnetic resonance elastography (MRE) even among patients with NAFLD. Methods: We performed a cross‐sectional analysis of patients who had undergone MRE and/or VCTE as well as an esophagogastroduodenoscopy. The patients were classified as having either a low risk or a high risk of varices. The optimal cut‐offs for ruling out esophageal varices were calculated for the MRE and VCTE liver stiffness measurement (LSM), the platelet count in an estimation cohort, and the cut‐offs were then evaluated using validation cohorts composed of patients who had undergone only MRE or VCTE. Results: The study included 627 patients (39% with NAFLD). The optimal cut‐off values for the MRE‐LSM and the platelet count were 4.2 kPa and 18.0 × 104/μL, respectively. An MRE‐LSM of 4.2 kPa plus a platelet count of 18.0 × 104/μL had a negative predictive value of 1.00 for both low‐risk plus high‐risk varices as well as for high‐risk varices in a validation cohort, enabling the presence of varices to be ruled out. Conclusions: Magnetic resonance elastography might enable a safer avoidance of screening endoscopy, with a smaller measurement error, among patient populations with a high prevalence of NAFLD. [ABSTRACT FROM AUTHOR]