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FibroScan®-based Score: Agile 4

Identification of cirrhosis in NAFLD patients.


Agile 4 Target

Cirrhosis is a leading cause of mortality worldwide.

Identifying cirrhosis early in patients helps to proactively manage the disease through screenings for liver-related complications such as hepatocellular carcinoma and esophageal varices.

Agile 4 Construction

Agile 4 combines LSM by VCTE™  with  easily accessible blood biomarkers (AST, ALT, Platelets) to help in the identification of cirrhosis in NAFLD patients to properly identify patients to start HCC and portal hypertension screening.


Agile 4 Performance

High clinical performances demonstrated in large external validation cohorts from different geographical origins.

agile 4 score - fibroscan echosens

Peer reviewed paper under submission
Sanyal et al., Enhanced diagnosis of advanced fibrosis and cirrhosis in non-alcoholic fatty liver disease patients with FibroScan®-based Agile scores.

Agile 4: tried and trusted


A novel noninvasive score including LSM by VCTE™ and routine clinical parameters improves the identification of cirrhosis among patients with NAFLD and may reduce the necessity of liver biopsy in this patient population.

AASLD 2020 | Quote from AASLD 2020 poster conclusion


Agile 4 and Agile 3+ well predict the occurrence of liverrelated events in patients with NAFLD. Particularly, rule-in cut-offs of both scores better identify at-risk patients than LSM alone. These results demonstrate the interest of those scores in the identification of patients requiring hepatocellular carcinoma and esophageal varices screening.

J. Boursier et all. | ILC 2021

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Webinar: Agile 4 presented at ILC 2021

Agile 4 is a class I medical device according to Directive 93/42/EEC. Agile 4 calculator is a tool for clinicians, computed from LSM (obtained from FibroScan® device), AST, ALT, platelets, diabetes status and gender, to aid in the identification of patients with suspicion of NAFLD as having cirhhosis. It was developed based on a pool of retrospective cohorts and published in peer-reviewed literature. Agile 4 is presented as an educational service intended for licensed healthcare professionals. While this score is about specific medical and health issues, it is not a substitute for or a replacement of personalized medical advice and is not intended to be used as the sole basis for making individualized medical or health-related decisions.


To access the Agile 4 User Guides, connect to myfibroscan.com:
Scores > Agile 4 > Learn more