2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T707,Steatotic liver disease (SLD) and liver fibrosis are major comorbidities in people with HIV (PWH). Guidelines recommend stepwise screening using the Fibrosis-4 (FIB-4) index followed by transient elastography (TE), yet its accuracy and the extent of FIB-4 misclassification in PWH remain uncertain. We evaluated the diagnostic performance of FIB-4 against TE, quantified missed fibrosis, and assessed whether metabolic and HIV-specific factors improve risk prediction. We conducted a multinational study of 4,917 PWH without viral hepatitis coinfection or hazardous alcohol intake undergoing TE screening across seven centers. SLD was defined by controlled attenuation parameter >275 dB/m and classified as metabolic dysfunction-associated SLD (MASLD) or metabolic dysfunction-associated alcohol-related liver disease (MetALD). Significant fibrosis (liver stiffness measurement [LSM] ≥8 kPa) was present in 12.6% of participants, advanced fibrosis (LSM ≥11 kPa) in 6.1%, and SLD in 21.7% (20.6% MASLD, 1.1% MetALD). FIB-4 showed modest accuracy for significant fibrosis (AUROC 0.69, 95% CI 0.67-0.72) and misclassified 36% of fibrosis cases as low risk (FIB-4 <1.3). Performance was poorer in MASLD than in non-MASLD (AUROC 0.60 vs 0.76; p <0.001). Participants with false-negative FIB-4 exhibited a more metabolic phenotype, including higher BMI and steatosis. Incorporating metabolic and HIV-specific factors improved discrimination and reclassification and enabled development of the FIB-HIV score, which outperformed FIB-4 (AUROC 0.78 vs 0.69; p <0.001). In PWH, liver fibrosis is common and frequently missed by FIB-4, particularly in MASLD. TE-centered screening strategies augmented by metabolic and HIV-specific indicators may improve early fibrosis detection and risk stratification.31:T9b6, Background and Aims: Steatotic liver disease (SLD) and liver fibrosis are major comorbidities in people with HIV (PWH). Guidelines recommend stepwise screening using the Fibrosis-4 (FIB-4) index followed by transient elastography (TE), yet its accuracy and the extent of FIB-4 misclassification in PWH remain uncertain. We evaluated the diagnostic performance of FIB-4 against TE, quantified missed fibrosis, and assessed whether metabolic and HIV-specific factors improve risk prediction. Approach and Results: We conducted a multinational study of 4,917 PWH without viral hepatitis coinfection or hazardous alcohol intake undergoing TE screening across seven centers. SLD was defined by controlled attenuation parameter >275 dB/m and classified as metabolic dysfunction-associated SLD (MASLD) or metabolic dysfunction-associated alcohol-related liver disease (MetALD). Significant fibrosis (liver stiffness measurement [LSM] ≥8 kPa) was present in 12.6% of participants, advanced fibrosis (LSM ≥11 kPa) in 6.1%, and SLD in 21.7% (20.6% MASLD, 1.1% MetALD). FIB-4 showed modest accuracy for significant fibrosis (AUROC 0.69, 95% CI 0.67–0.72) and misclassified 36% of fibrosis cases as low risk (FIB-4 <1.3). Performance was poorer in MASLD than in non-MASLD (AUROC 0.60 vs 0.76; p <0.001). Participants with false-negative FIB-4 exhibited a more metabolic phenotype, including higher BMI and steatosis. Incorporating metabolic and HIV-specific factors improved discrimination and reclassification and enabled development of the FIB-HIV score, which outperformed FIB-4 (AUROC 0.78 vs 0.69; p <0.001). Conclusions: In PWH, liver fibrosis is common and frequently missed by FIB-4, particularly in MASLD. TE-centered screening strategies augmented by metabolic and HIV-specific indicators may improve early fibrosis detection and risk stratification. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Transient Elastography: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Transient Elastography (modality). Clinician-written summaries and actionable practice insights. 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Clinicians should consider longitudinal monitoring with validated non-invasive tests as a routine strategy for personalized LRE risk stratification in MASLD."}},{"doi":"10.14309/ajg.0000000000004191","pmid":"42678758","title":"Do Patients on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Require Longer Fasting Prior to Vibration Controlled Transient Elastography?","journal_title":"American Journal of Gastroenterology","journal_issn":"0002-9270","published_at":"2026-09-01T00:00:00.000Z","url":"https://doi.org/10.14309/ajg.0000000000004191","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-08T06:32:12.850Z","updated_at":"2026-09-08T06:32:12.850Z","tags":[{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"condition","value":"Cirrhosis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"sample_size","value":"n=23","value_numeric":23},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"study_design","value":"Prospective Observational Study","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"No specific GLP-1 RA agents, doses, or drug durations are reported in the abstract, limiting applicability to individual agents.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"Sex of participants is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"Study design is not explicitly labeled in the abstract; classified as prospective observational based on context (serial measurements after standardized meal). Confirm in full text.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"The proportion of patients who required 4 hours to return to baseline is not quantified — clinicians should interpret the 'subset' caveat cautiously.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated whether the standard 3-hour fasting recommendation before vibration-controlled transient elastography (VCTE) remains adequate in patients on GLP-1 receptor agonists (GLP-1 RAs), which delay gastric emptying and alter postprandial hemodynamics. 23 participants (including 12 with cirrhosis) underwent serial liver stiffness measurements (LSM) after a standardized meal.","key_result":"LSM peaked at 20.6% above baseline at 30–60 minutes post-meal, then fell to <10% above baseline by 3 hours. Most patients returned to baseline by 3–4 hours, supporting the adequacy of a 3-hour fast, though some required up to 4 hours.","limitations":"Very small sample size (n=23) limits generalizability. The study does not stratify results by GLP-1 RA agent, dose, or duration of use. The subset requiring 4 hours is not precisely quantified.","practice_takeaway":"A standard 3-hour fast before VCTE appears adequate for most patients on GLP-1 RAs, but clinicians should be aware that a subset may need 4 hours. Consider extending the fast to 4 hours when results seem unexpectedly elevated."}},{"doi":"10.1071/py25195","pmid":"42070789","title":"Acceptability of an integrated care program to identify patients at risk of advanced chronic liver disease in Australian primary care settings","journal_title":"Australian Journal of Primary Health","journal_issn":"1448-7527","published_at":"2026-05-04T00:00:00.000Z","url":"http://hdl.handle.net/1959.4/107718","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-17T13:21:40.859Z","updated_at":"2026-05-17T13:21:40.859Z","tags":[{"paper_doi":"10.1071/py25195","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"condition","value":"Advanced Chronic Liver Disease","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"condition","value":"Liver Cirrhosis","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"modality","value":"Integrated Care Program","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"sample_size","value":"n=11","value_numeric":11},{"paper_doi":"10.1071/py25195","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"study_design","value":"Qualitative Study","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"No patient-reported outcomes or patient interviews were included, which is an acknowledged gap by the authors.","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"Sample size for qualitative interviews is very small (n=11), and only 5 of 9 pilot practices participated, limiting transferability of findings.","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"The POLAR software and CHL model are specific to this pilot — findings about tool usability may not apply to other ACLD screening platforms.","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"The study reflects a single pilot program in Sydney, Australia; results may not generalise to other health systems or countries.","value_numeric":null}],"summaries":{"what_studied":"This qualitative study examined the feasibility and acceptability of the Liver Toolkit (LTK) — an integrated ACLD screening and management program piloted across nine general practices in Sydney, Australia — among 11 general practice and hospital staff (4 GPs, 1 practice manager, 5 Clinical Hospital Liaison staff, 1 PHN project staff), using the Theoretical Framework of Acceptability (TFA) to guide thematic analysis of semi-structured interviews conducted in 2023.","key_result":"Acceptability was mixed: staff recognised the LTK's value (32,270 patients screened; 703 flagged at risk; 179 successfully recalled), but key barriers included low GP self-efficacy with the POLAR software, high burden (4–5 hours per recall list), poor workflow coherence (67 metrics in reports vs. 10–15 relevant), and over-sensitivity leading to many false-positive recalls; hospital-led CHL support was the main enabler.","limitations":"- Small sample (n=11) from only 5 of 9 practices; indirect recruitment via external organisations likely reduced participation.\n- No patient perspectives were captured, limiting understanding of the program's impact from the patient side.\n- Interviews conducted during post-COVID-19 work pressures, which may have heightened perceived burden.","practice_takeaway":"GPs adopting ACLD screening tools should anticipate significant workflow and training demands — embedding decision-support directly into existing clinical software and using nurse-led recall may be key to sustainable implementation. Until the POLAR tool is simplified and integrated, broad roll-out in general practice is premature."}},{"doi":"10.1097/hep.0000000000001773","pmid":"42065895","title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study","journal_title":"Hepatology","journal_issn":"0270-9139","published_at":"2026-05-01T00:00:00.000Z","url":"https://doi.org/10.1097/hep.0000000000001773","source_score":22,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1097/hep.0000000000001773","days":"7","issn":"0270-9139","rank":"5","field":"Clinical Medicine","score":"22","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1097/HEP.0000000000001773","title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study.","journal":"Hepatology (Baltimore, Md.)","methods":"","results":"","abstract":"$30","keywords":["FIB-HIV","MASLD","lean phenotype","metabolic risk factors","misclassification","transient elastography"],"pubmed_id":"42065895","conclusions":"","publication_date":"2026-05-01T00:00:00"},"crossref":{"DOI":"10.1097/hep.0000000000001773","URL":"https://doi.org/10.1097/hep.0000000000001773","ISSN":["0270-9139","1527-3350"],"link":[{"URL":"https://journals.lww.com/10.1097/HEP.0000000000001773","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study"],"author":[{"given":"Felice","family":"Cinque","sequence":"first","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"}]},{"given":"Sahar","family":"Saeed","sequence":"additional","affiliation":[{"name":"Public Health Sciences, Queen’s University, Kingston, ON, Canada"}]},{"given":"Francesca","family":"Farina","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"San Raffaele Hospital, Milan, Italy"}]},{"given":"Dana","family":"Kablawi","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"}]},{"given":"Jihoon","family":"Lim","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada"}]},{"given":"Antonio","family":"Cascio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, Palermo, Italy"}]},{"given":"Claudia","family":"Gioè","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, Palermo, Italy"}]},{"given":"Emmanuel","family":"Tsochatzis","sequence":"additional","affiliation":[{"name":"UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK"}]},{"given":"Rosa","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"},{"name":"SC Medicina Indirizzo Metabolico, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy"}]},{"given":"Ahmed","family":"Cordie","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"}]},{"given":"Rahma","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"}]},{"given":"Ahmed M.","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt"}]},{"given":"Gamal","family":"Esmat","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"},{"name":"Research Center, Badr University in Cairo, Badr City, Egypt"}]},{"given":"Alessandra","family":"Bandera","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"},{"name":"Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy"}]},{"given":"Jovana","family":"Milic","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy"}]},{"given":"Dominik","family":"Benke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Fauzi","family":"Elamouri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Jürgen K.","family":"Rockstroh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Giovanni","family":"Guaraldi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy"}]},{"given":"Giada","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada"},{"name":"Division of Gastroenterology and Hepatology, Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada"}]}],"issued":{"date-parts":[[2026,5,1]]},"member":"276","prefix":"10.1097","source":"Crossref","volume":null,"created":{"date-time":"2026-05-01T16:00:14Z","timestamp":1777651214000,"date-parts":[[2026,5,1]]},"indexed":{"date-time":"2026-05-07T10:15:07Z","timestamp":1778148907187,"date-parts":[[2026,5,7]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.1097/HEP.0000000000001773"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","value":"2026-02-04"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","value":"2026-04-04"}],"deposited":{"date-time":"2026-05-07T10:00:49Z","timestamp":1778148049000,"date-parts":[[2026,5,7]]},"issn-type":[{"type":"print","value":"0270-9139"},{"type":"electronic","value":"1527-3350"}],"published":{"date-parts":[[2026,5,1]]},"publisher":"Ovid Technologies (Wolters Kluwer Health)","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1097/lww.0000000000001000","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Hepatology"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,1]]},"references-count":0,"short-container-title":[],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1097/hep.0000000000001773","is_oa":false,"title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening 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Disease","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"modality","value":"Fibrosis Biomarker Index","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"sample_size","value":"n=4917","value_numeric":4917},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"warning","value":"Age distribution and sex breakdown of the cohort are not specified in the abstract; age_group and sex tags reflect reasonable assumptions for an HIV clinic population.","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"warning","value":"The FIB-HIV score is newly derived in this study; external validation data are not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"warning","value":"The full text retrieved appears to contain an unrelated document (a 2020 GI Society joint statement on racism), not the actual study body. Summary and tags are based solely on the abstract, which provides sufficient detail for most fields but precludes extraction of subgroup data, adjustment variables, or methodological specifics from the full text.","value_numeric":null}],"summaries":{"what_studied":"Diagnostic accuracy of FIB-4 index vs. transient elastography (TE) for significant liver fibrosis in 4,917 people with HIV (PWH) without viral hepatitis coinfection or hazardous alcohol use, across seven multinational centers; also assessed whether metabolic and HIV-specific factors could improve risk prediction.","key_result":"FIB-4 showed only modest accuracy for significant fibrosis (AUROC 0.69) and missed 36% of cases (false-negative rate at FIB-4 <1.3 cutoff); performance was worse in MASLD vs. non-MASLD (AUROC 0.60 vs. 0.76, p<0.001). A new FIB-HIV score incorporating metabolic and HIV-specific factors outperformed FIB-4 (AUROC 0.78 vs. 0.69, p<0.001). Significant fibrosis (LSM ≥8 kPa) was present in 12.6% and SLD in 21.7% of participants.","limitations":"- Observational, cross-sectional design limits causal inference and assessment of clinical outcomes.\n- TE used as reference standard rather than liver biopsy, which may affect fibrosis classification accuracy.\n- The FIB-HIV score was derived and not externally validated in an independent cohort.","practice_takeaway":"FIB-4 alone should not be relied upon to rule out significant fibrosis in PWH, especially those with metabolic risk factors or MASLD — TE-based screening is more appropriate in this population. Clinicians should consider metabolic and HIV-specific factors when stratifying fibrosis risk in PWH."}}],"initialOffset":4,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Transient Elastography"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Transient Elastography"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Transient Elastography"}}}]]

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