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Disclosures: Andrea Lindfors: Gilead Sciences: The study was partly financed by Gilead Sciences, Hannes Hagstrm: Nothing to Disclose, Rickard Strandberg: Nothing to Disclose 853 AGILE3+ ENCOMPASSES THE TWO-STEP APPROACH NEEDED TO ENHANCE DIAGNOSTIC ACCURACY OF ADVANCED FIBROSIS IN PATIENTS WITH SUSPECTED MASLD Savvoula Savvidou 1 Polyxeni Agorastou 2 Effrosyni Tsirogianni 2 Stefania Kiapidou 2 Ioanna Papagiouvani 2 Theodora Oikonomou 2 Lazaros Sideras 2 Prodromos Hytiroglou 3 Ioannis Goulis 2 , 1 Hippokrateio University Hospital of Thessaloniki, 2 Hippokrateio University Hospital of Thessaloniki, Greece, 3 Department of Pathology, Medical School of Aristotle University of Thessaloniki Background: According to national Greek guidelines (2021) regarding diagnostic approach of suspected Metabolic dysfunction Associated Steatotic Liver Disease (MASLD), liver stiffness measurement (LSM) is suggested only to patients (pts) with ultrasonographic evidence of fatty liver, presence of at least one cardiometabolic factor in the absence of other aetiology for secondary hepatic steatosis (alcohol, drugs, viral hepatitis, etc), and intermediate risk for advanced fibrosis assessed by FIB-4 score