Related Experiment Video
Updated: Aug 10, 2026
In Vitro Modeling of Fat Deposition in Metabolic Dysfunction-Associated Steatotic Liver Disease
Published on: July 19, 2024
Non-invasive Tests for the Prediction of Liver-related Events in Patients with MASLD: A Systematic Review and
Xinkai Wang1, Xue Dong1, Luodan Qian1
1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China (X.W., X.D., L.Q., Z.Y., D.Y., Y.N.).
Rationale And Objectives:
While guidelines recommend tests like the FIB-4 index and liver stiffness measurements (LSM) to identify high-risk Metabolic dysfunction-associated steatotic liver disease (MASLD) patients, their actual accuracy in predicting liver-related events (LREs) remains unclear. Here, we systematically evaluate their prognostic performance to better inform clinical decisions.
Materials And Methods:
We systematically searched Cochrane Library, Embase, PubMed and Web of Science (up to January 7, 2026), to identify studies utilizing non-invasive tests (NITs) for predicting incident LREs and reporting their prognostic performance. Subgroup analyses and meta-regression were performed based on dataset characteristics to explore potential sources of heterogeneity. All pooled analyses were conducted using a random-effects model.
Results:
This meta-analysis included a total of 30 studies involving 67,533 patients with MASLD. The results demonstrated that for predicting incident LREs, the pooled C-index for Vibration-Controlled Transient Elastography (VCTE), the FIB-4 index, and Magnetic Resonance Elastography (MRE) were 0.83 (95% CI: 0.79-0.87), 0.82 (95% CI: 0.78-0.85), and 0.78 (95% CI: 0.64-0.91), respectively. In the evaluation of secondary outcomes, the pooled C-index of VCTE for predicting hepatocellular carcinoma (HCC) was 0.78 (95% CI: 0.70-0.86). Regarding mortality risk prediction, the pooled C-index for VCTE and the FIB-4 index were 0.83 (95% CI: 0.76-0.89) and 0.75 (95% CI: 0.66-0.84), respectively.
Conclusion:
The FIB-4 index and LSM measured by VCTE exhibit robust prognostic discrimination for LREs in MASLD. Existing evidence supports the FIB-4 index and VCTE as routine non-invasive prognostic tests. Furthermore, the prognostic performance of MRE requires additional validation in future research.
