{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T20:42:42Z","timestamp":1767732162133,"version":"build-2238731810"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017141","name":"Samsung Medison","doi-asserted-by":"publisher","award":["None"],"award-info":[{"award-number":["None"]}],"id":[{"id":"10.13039\/100017141","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002560","name":"Soonchunhyang University","doi-asserted-by":"publisher","award":["None"],"award-info":[{"award-number":["None"]}],"id":[{"id":"10.13039\/501100002560","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec018\">\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Chronic liver disease (CLD) represents a significant global health challenge necessitating the evaluation of liver fibrosis. This study aimed to evaluate the diagnostic performance of microvascular flow (MV-flow) imaging in evaluating liver fibrosis and compare it with other non-invasive tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec019\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between July 2020 and June 2022, we prospectively enrolled patients scheduled for liver biopsy, concurrently measuring MV-flow imaging, transient elastography (TE), and two-dimensional shear wave elastography (2D-SWE) as part of the assessment process. We evaluated the diagnostic performance of MV-flow imaging, 2D-SWE, and TE based on histologic staging of liver fibrosis using the area under the receiver operating characteristic curve (AUROC), and calculated the optimal cut-off value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec020\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 89 participants were included. Non-alcoholic fatty liver disease was the most common etiology of CLD (32.6%). The liver fibrosis stage distribution was as follows: stage 0 (11.2%), stage 1 (31.5%), stage 2 (25.8%), stage 3 (13.5%), and stage 4 (18.0%). The MV-flow scoring system\u2019s cut-off values and AUROCs for predicting stage 2, stage 3, and cirrhosis were 2.1 (0.836), 2.5 (0.955), and 2.9 (0.942), respectively. The MV-flow scoring system\u2019s performance in predicting advanced fibrosis (stage 3) was comparable to TE (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.170) and 2D-SWE (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.456). MV-flow imaging misclassified 9.0% of patients in predicting advanced fibrosis. A sequential combination of 2D-SWE and MV-flow imaging, following the specified cut-off, minimized the risk of missing advanced fibrosis to 1.2%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec021\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MV-flow imaging is an effective tool for predicting liver fibrosis stage. Integrating MV-flow imaging with 2D-SWE can enhance the assessment of liver fibrosis in patients with CLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0322102","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T13:36:14Z","timestamp":1749044174000},"page":"e0322102","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic performance of microvascular flow imaging for noninvasive assessment of liver fibrosis in chronic liver disease"],"prefix":"10.1371","volume":"20","author":[{"given":"Hae Won","family":"Yoo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan Jin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong-Ju","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sae Hwan","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soung Won","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Young","family":"Jang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gab Jin","family":"Cheon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-3623","authenticated-orcid":true,"given":"Young Seok","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong Soo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-777X","authenticated-orcid":true,"given":"Sang Gyune","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"issue":"5","key":"pone.0322102.ref001","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1002\/hep.31173","article-title":"Changes in the global burden of chronic liver diseases from 2012 to 2017: the growing impact of NAFLD","volume":"72","author":"JM Paik","year":"2020","journal-title":"Hepatology"},{"issue":"5","key":"pone.0322102.ref002","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/cld.1061","article-title":"Global epidemiology of chronic liver disease","volume":"17","author":"S Cheemerla","year":"2021","journal-title":"Clin Liver Dis (Hoboken)"},{"issue":"15","key":"pone.0322102.ref003","doi-asserted-by":"crossref","first-page":"8139","DOI":"10.3390\/ijms22158139","article-title":"Diagnosis and therapeutic management of liver fibrosis by MicroRNA","volume":"22","author":"T Tadokoro","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"2","key":"pone.0322102.ref004","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1172\/JCI24282","article-title":"Liver fibrosis","volume":"115","author":"R Bataller","year":"2005","journal-title":"J Clin Invest"},{"issue":"3","key":"pone.0322102.ref005","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jhep.2021.05.025","article-title":"EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 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