Prospective Comparison of 2D-Shear Wave Elastography and Vibration-Controlled Transient Elastography in Assessing Liver Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.

RATIONALE AND OBJECTIVES

This prospective study aimed to compare the diagnostic performance of 2D-shear wave elastography (2D-SWE) with vibration-controlled transient elastography (VCTE) for assessing liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

MATERIALS AND METHODS

Ninety-one participants (mean age: 42±13 years; 52 males) suspected of MASLD and scheduled for liver biopsy were enrolled at the Clinical Trial Center of our hospital between June 2024 and December 2024. All participants underwent both VCTE and 2D-SWE examinations on the same day as their liver biopsy, which served as the gold standard for assessing fibrosis. Diagnostic accuracy was analyzed using receiver operating characteristic (ROC) curves.

RESULTS

The areas under the ROC curves (AUCs) for 2D-SWE in diagnosing liver fibrosis (F ≥ 1) and significant fibrosis (F ≥ 2) were 0.92 (95% CI: 0.83-0.97) and 0.93 (95% CI: 0.85-0.98), respectively. The optimal cutoff values were 6.1 kPa and 7.66 kPa, yielding sensitivities of 87.8% and 84% and specificities of 85.3% and 94%, respectively. For VCTE, the AUCs were 0.84 (95% CI: 0.74-0.91) and 0.90 (95% CI: 0.81-0.96), with cutoff values of 6.3 kPa and 8.1 kPa, sensitivities of 92.7% and 76%, and specificities of 64.7% and 90%, respectively. No statistically significant difference was observed in the diagnostic performances of 2D-SWE and VCTE for liver fibrosis or significant fibrosis, with P-values of 0.09 and 0.44, respectively.

CONCLUSION

2D-SWE demonstrated high diagnostic accuracy for detecting liver fibrosis and significant fibrosis in MASLD patients, performing comparably to VCTE.