Assessment of Liver Fibrosis with Multisample Point Shear Wave Elastography in Obese Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease

To evaluate the diagnostic performance of multisample point shear wave elastography (pSWE) for liver fibrosis in obese patients with metabolic dysfunction-associated steatotic liver disease (MASLD) using liver biopsy as the reference standard and to compare it with the FIB-4 index and aspartate to platelet ratio index (APRI).

Patients with obesity who met the diagnostic criteria for MASLD between April 2023 and December 2024 were selected for this retrospective single-centre study. Liver stiffness measurements were reported as median values of measurements, and Auto-pSWVs (m/s) were measured using the multisample pSWE technique. The diagnostic performance of auto shear wave velocities (Auto-pSWVs), FIB-4 index and APRI for significant fibrosis (≥F2) and advanced fibrosis (≥F3) of the liver was evaluated and compared using receiver operating characteristic curves with liver biopsy as the criterion. The correlation between Auto-pSWVs and the clinical variables of the subjects was evaluated.

Data from 241 patients were analysed. Auto-pSWVs were positively correlated with the pathological diagnosis of liver fibrosis (r=0.34, p<0.001), and the liver fibrosis stage was an independent risk factor for Auto-pSWVs (beta coefficient: 0.42, p< 0.001). In addition, Auto-pSWVs was superior to FIB-4 index and APRI when comparing the diagnostic performance of significant liver fibrosis (≥F 2) and advanced fibrosis (≥F3) (p < 0.05). The AUC of Auto-pSWVs was 0.75 (95% CI 0.66-0.85) and 0.96 (95% CI 0.89-1.0) in the ≥ F2 and ≥ F3 groups, respectively. The cut-off value for Auto-pSWVs were determined as follows: grade F2 ≥ 1.02 m/s; and grade F3 ≥ 1.30 m/s.

Multisample pSWE appears to be a valuable tool for the diagnosis of liver fibrosis in obese patients with MASLD.