Real‐world assessment of SmartExam, a novel FibroScan computational method: A retrospective single‐center cohort study

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.