To compare the prognostic accuracy of vibration-controlled transient elastography (VCTE)-based liver stiffness measurement (LSM) with liver biopsy for predicting liver-related events (LREs) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
Key Findings:
Mean age of participants was 51.9 years; 57.3% were men.
Median baseline LSM was 8.8 kPa; one-third had advanced fibrosis (F3–F4).
During a median follow-up of 56.6 months, 126 patients (3.6%) developed LREs, primarily due to hepatic decompensation.
Five-year AUROC values for LSM and histology were nearly identical (0.870 vs 0.869).
No significant differences in discrimination improvement metrics were observed.
Interpretation:
LSM obtained by VCTE shows comparable prognostic performance to liver biopsy for predicting LREs in MASLD, suggesting it may serve as a practical alternative in clinical settings.
Limitations:
The study's findings are based on a specific cohort and may not be generalizable to all populations.
Potential biases inherent in observational studies.
Conclusion:
LSM via VCTE may be a viable surrogate prognostic endpoint in clinical trials and for risk stratification in MASLD.
