Combi-Elastography versus Transient Elastography for Assessing the Histological Severity of Metabolic Dysfunction-Associated Steatotic Liver Disease
Yun Kyu Lee,
Dong Hyeon Lee,
Sae Kyung Joo,
Heejoon Jang,
Young Ho So,
Siwon Jang,
Dong Ho Lee,
Jeong Hwan Park,
Mee Soo Chang,
Won Kim,
Innovative Target Exploration of NAFLD (ITEN) Consortium
Affiliations
Yun Kyu Lee
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Dong Hyeon Lee
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Sae Kyung Joo
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medic
Heejoon Jang
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medic
Young Ho So
Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
Siwon Jang
Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
Dong Ho Lee
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Jeong Hwan Park
Department of Pathology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
Mee Soo Chang
Department of Pathology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
Won Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Innovative Target Exploration of NAFLD (ITEN) Consortium
Background/Aims: Combi-elastography is a B-mode ultrasound-based method in which two elastography modalities are utilized simultaneously to assess metabolic dysfunction-associated steatotic liver disease (MASLD). However, the performance of combi-elastography for diagnosing metabolic dysfunction-associated steatohepatitis (MASH) and determining fibrosis severity is unclear. This study compared the diagnostic performances of combi-elastography and vibration-controlled transient elastography (VCTE) for identifying hepatic steatosis, fibrosis, and high-risk MASH.Methods: Participants who underwent combi-elastography, VCTE, and liver biopsy were selected from a prospective cohort of patients with clinically suspected MASLD. Combi-elastography-related parameters were acquired, and their performances were evaluated using area under the receiver-operating characteristic curve (AUROC) analysis.Results: A total of 212 participants were included. The diagnostic performance for hepatic steatosis of the attenuation coefficient adjusted by covariates from combi-elastography was comparable to that of the controlled attenuation parameter measured by VCTE (AUROC, 0.85 vs 0.85; p=0.925). The performance of the combi-elastography-derived fibrosis index adjusted by covariates for diagnosing significant fibrosis was comparable to that of liver stiffness measured by VCTE (AUROC, 0.77 vs 0.80; p=0.573). The activity index from combi-elastography adjusted by covariates was equivalent to the FibroScan-aspartate aminotransferase score in diagnosing high-risk MASH among participants with MASLD (AUROC, 0.72 vs 0.74; p=0.792).Conclusions: The performance of combi-elastography is similar to that of VCTE when evaluating histology of MASLD.
