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Petitjean 4 and Arun Sanyal 5 , (1)Pharmanest, (2)Bristol Myers Squibb, (3)Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, (4)Pharmanest Inc, (5)Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, VA Background: Manual histological evaluation of liver biopsy is the gold standard for fibrosis staging in Non-Alcoholic Steatohepatitis (NASH), but it is limited by its inter and intra-reader variability

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Thinner needles (32G) cause less pain but may require slightly more pressure to inject, while 31G needles offer a balance between comfort and ease of use