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Shear wave elastography demonstrates similar risk stratification performance to vibration-controlled transient
Jaejun Lee1,2, Hyun Yang1,2, Si Hyun Bae1,2
1Division of Hepatology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Shear wave elastography (SWE) offers comparable risk stratification for metabolic dysfunction-associated liver disease (MASLD) to vibration-controlled transient elastography (VCTE). Both methods effectively predict liver-related events (LREs) using established algorithms.
Area of Science:
- Hepatology
- Medical Imaging
- Non-invasive Diagnostics
Background:
- Metabolic dysfunction-associated liver disease (MASLD) risk stratification is crucial for patient management.
- The utility of shear wave elastography (SWE) in MASLD risk stratification requires further clarification.
- Comparison with vibration-controlled transient elastography (VCTE) is essential for validating new diagnostic tools.
Purpose of the Study:
- To evaluate the effectiveness of SWE in two-step MASLD risk stratification.
- To compare the performance of SWE against VCTE using American Gastroenterological Association (AGA) and European Association for the Study of the Liver (EASL) algorithms.
- To assess the predictive accuracy of both elastography techniques for liver-related events (LREs).
Main Methods:
- A cohort of 2,817 MASLD patients undergoing both VCTE and SWE were analyzed.
- Risk stratification was performed using two-step AGA- and EASL-based algorithms.
- Liver-related events (LREs) served as the primary endpoint for predictive accuracy assessment.
Main Results:
- Both AGA-SWE and EASL-SWE algorithms successfully stratified LRE risk, showing significantly higher risks in intermediate- and high-risk groups compared to the low-risk group.
- Area under the curve (AUC) values for predicting LREs at 60 months were comparable between SWE and VCTE for both AGA (0.770 vs. 0.775) and EASL (0.804 vs. 0.805) algorithms.
- A strong correlation was observed between SWE and VCTE measurements (Spearman's ρ = 0.713).
Conclusions:
- SWE-based two-step risk stratification demonstrates similar predictive performance to VCTE-based models for LREs in MASLD patients.
- While SWE shows comparable efficacy, formal equivalence to VCTE has not been established.
- SWE represents a viable alternative for MASLD risk stratification, particularly when VCTE is unavailable or technically challenging.
